Persistent foul smelling purulent unilateral nasal discharge in a young child without other respiratory symptoms should raise suspicion for a retained nasal foreign body, even without a history of witnessed foreign body insertion.
- Indications for otolaryngology referral may include non-visualized posterior FBs, impacted FBs, or unsuccessful initial attempts at FB removal
Diagnosis is clinical
Prior to removal, the provider may consider using oxymetazoline drops to shrink the mucous membrane
Viral URI does not present with foul-smelling nasal discharge.
Acute sinusitis may present with purulent nasal discharge, but the observation of a bright light reflection suggests a foreign body.
Allergic rhinitis is seasonal, associated with sneezing and other allergy-related symptoms.
Nasal foreign body