Not all cases of hay fever or vasomotor rhinitis are obviously recognizable. Seasonal cases may be mild, simulating almost perfectly infectious coryzas. The vasomotor rhinitis accompanying bronchial asthma and often its possible etiologic basis may be of such identical mildness that its presence is even denied by the patient and overlooked by the examiner. Also, a single hay fever antigen, such as feathers or some house or occupational dust, may be of a chronic perennial and non-seasonal character, or a succession of pollen antigens in some climates may produce more or less chronic symptoms. Positive skin tests for determining the allergic state are not immediately or invariably secured when reasonably expected. Children with chronic vasomotor rhinitis aften present the typical mouth breathing and facies ascribable to tonsillar and adenoidal hypertrophy, with failure of expected operative relief. Under certain conditions, the roentgenographic densities of vasomotor rhinitis can easily be mistaken for
KAHN IS, STOUT BF. ALLERGY AND INFECTION: PRACTICAL VALUE OF CYTOLOGIC EXAMINATION OF THE NASAL SMEAR IN DIFFERENTIAL DIAGNOSIS. JAMA. 1932;99(18):1494–1496. doi:10.1001/jama.1932.02740700034007
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