Case Presentation :

• A 24-year-old male presented to the outpatient department with complaints of:
  1. Paroxysmal sneezing, predominantly in the early morning
  2. Persistent nasal congestion
  3. Profuse watery rhinorrhea
  4. Intermittent dry cough for 5 days, worse at night
• The patient reported recurrent, seasonal episodes over the past 3 years, typically exacerbated during weather transitions and exposure to dust. The current episode began insidiously and progressed over 5 days, with increasing nasal blockage and rhinorrhea.

Past History :

1. No prior diagnosis of Asthma, chronic sinusitis, or nasal polyposis
2. No history suggestive of atopic dermatitis

Family History :

1. Mother with a history suggestive of atopic disease (allergic rhinitis)

Clinical Examination :

1. Nasal mucosa: Pale, boggy, and edematous
2. Inferior turbinate hypertrophy present
3. Profuse clear nasal discharge

Respiratory Examination :

1. Bilateral vesicular breath sounds
2. No wheeze, crackles, or rhonchi

Diagnosis :

• Moderately Persistent Allergic Rhinitis with Upper Airway Cough Syndrome

Management :

• The patient was initiated on a combination therapy consisting of Chlorpheniramine Phenylephrine and Dextromethorphan.

Adjunctive Therapy :

1. Saline nasal irrigation.
2. Steam inhalation twice daily
3. Short course of intranasal decongestant (if severe congestion)