Differential Diagnosis for Right-Sided Epistaxis
- Single Most Likely Diagnosis
- Dry air or nasal trauma: This is the most common cause of epistaxis, especially if the patient has recently experienced nasal dryness or minor trauma to the nose.
- Other Likely Diagnoses
- Hypertension: Uncontrolled high blood pressure can cause blood vessels in the nose to become fragile and prone to bleeding.
- Nasal septal deviation or other anatomical abnormalities: Abnormalities in the nasal passages can increase the risk of epistaxis.
- Allergies or upper respiratory infections: Inflammation and congestion in the nasal passages can increase the risk of bleeding.
- Use of anticoagulant medications: Medications that thin the blood can increase the risk of epistaxis.
- Do Not Miss Diagnoses
- Nasopharyngeal cancer: Although rare, nasopharyngeal cancer can cause epistaxis, and it is essential to rule out this diagnosis, especially in older adults or those with a history of smoking.
- Juvenile nasopharyngeal angiofibroma (in adolescent males): This rare tumor can cause recurrent and severe epistaxis.
- Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome): This genetic disorder can cause vascular malformations that increase the risk of epistaxis.
- Arteriovenous malformation: Abnormal connections between arteries and veins can cause epistaxis, and it is crucial to diagnose and treat this condition to prevent further complications.
- Rare Diagnoses
- Granulomatosis with polyangiitis (Wegener's granulomatosis): This autoimmune disorder can cause inflammation and bleeding in the nasal passages.
- Sarcoidosis: This condition can cause granulomas to form in the nasal passages, increasing the risk of epistaxis.
- Amyloidosis: The deposition of abnormal proteins in the nasal passages can cause bleeding and other symptoms.