What are the causes of epistaxis (nosebleed)?

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Differential Diagnosis for Bloody Nose

  • Single most likely diagnosis
    • Dry air or nasal trauma: This is the most common cause of a bloody nose (epistaxis), often due to dry air causing nasal mucosa dryness and cracking, or minor trauma from picking or blowing the nose.
  • Other Likely diagnoses
    • Allergies: Allergic reactions can lead to nasal congestion and irritation, increasing the risk of a bloody nose.
    • Upper respiratory infections: Viral or bacterial infections, such as the common cold or sinusitis, can cause inflammation and bleeding in the nasal passages.
    • Hypertension: High blood pressure can cause blood vessels in the nose to become fragile and prone to bleeding.
    • Nasal polyps or tumors: Growths in the nasal passages can irritate the surrounding tissue and cause bleeding.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Nasopharyngeal cancer: Although rare, this type of cancer can cause recurrent or severe nosebleeds and should not be overlooked.
    • Coagulopathy (e.g., hemophilia, von Willebrand disease): Bleeding disorders can cause prolonged or severe bleeding from the nose.
    • Arteriovenous malformation (AVM): A rare condition where abnormal blood vessels can cause severe and recurrent nosebleeds.
    • Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome): A genetic disorder that can cause abnormal blood vessels and recurrent nosebleeds.
  • Rare diagnoses
    • Granulomatosis with polyangiitis (Wegener's granulomatosis): A rare autoimmune disorder that can cause inflammation and bleeding in the nasal passages.
    • Sarcoidosis: A condition that can cause inflammation and granulomas in various parts of the body, including the nose.
    • Amyloidosis: A rare condition where abnormal proteins accumulate in the body, potentially causing bleeding and other symptoms.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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