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What Causes Clear And Foul Smelling Nasal Drip While Bending Over?
Question: I have had water like substance dripping from my nose for a quite some time when ever I bend over or tilt my head down for things like eating or reading. I have developed a horrid smell that I can only describe as rot. Not sulfuric, but more like bad meat. I have tried things like antihistamines and gufienistin (sp?) to try to dry up this drip to no avail. The smell came with a fever 8 days ago. Running anywhere from 100.9-103.0. Other symptoms that started at that time where a very severe head and neck ache. Nausea, vomiting, chills, very sleepy, sleeping more than normal. My chest is clear and no cough. My sinuses aren't full. No sore throat. I went to my doctor 4 days ago. Was diagnosed via rapid test, no culture, that I had strep. Was put on Augmentin 875mg 2x day. Now after 8 doses of the antibiotics, I am not feeling any better. Never had a sore throat during any of this. I am very concerned that my doctor has missed something as I am still running mild to moderate fevers. Should I seek a second opinion?
Brief Answer:
Rule out a CSF leak.
Detailed Answer:
Hi,
Thank you for your query.
1. Yes, you should consult an ENT Specialist or a Neurologist. This clear nasal drip after bending or tilting the head is known as the 'Reservoir Sign'.
2. Rule out CSF (Cerebro-Spinal Fluid) Rhinorrhea (leak) which can present with such symptoms.
3. You should get the fluid collected in a sterile container and get it tested to rule out a CSF (Cerebro Spinal Fluid) leak. Get a Beta-2 Transferrin test on the fluid, if available.
2. A simple test is the 'Handerchief Test': Normal nasal secretions contain mucus which will stain and stiffen a soft handkerchief on drying, but CSF will not.
3. Since your rhinorrhea is one sided, get a CT PNS (Para Nasal Sinuses). done. If a CSF leak is suspected, a CT cisternography and MRI with contrast should be done.
4. Upload these test reports for further treatment options. If your tests are normal, this will settle down with routine medication.
5. I would recommend an urgent referral and admission for treatment, if necessary.
I hope that I have answered your queries. If you have any further questions, I will be available to answer them.
Regards.
Rule out a CSF leak.
Detailed Answer:
Hi,
Thank you for your query.
1. Yes, you should consult an ENT Specialist or a Neurologist. This clear nasal drip after bending or tilting the head is known as the 'Reservoir Sign'.
2. Rule out CSF (Cerebro-Spinal Fluid) Rhinorrhea (leak) which can present with such symptoms.
3. You should get the fluid collected in a sterile container and get it tested to rule out a CSF (Cerebro Spinal Fluid) leak. Get a Beta-2 Transferrin test on the fluid, if available.
2. A simple test is the 'Handerchief Test': Normal nasal secretions contain mucus which will stain and stiffen a soft handkerchief on drying, but CSF will not.
3. Since your rhinorrhea is one sided, get a CT PNS (Para Nasal Sinuses). done. If a CSF leak is suspected, a CT cisternography and MRI with contrast should be done.
4. Upload these test reports for further treatment options. If your tests are normal, this will settle down with routine medication.
5. I would recommend an urgent referral and admission for treatment, if necessary.
I hope that I have answered your queries. If you have any further questions, I will be available to answer them.
Regards.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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