Differential Diagnosis for Spontaneous Nose Bleed
- Single most likely diagnosis
- Dry air or nasal mucosa irritation: This is the most common cause of spontaneous nose bleeds, especially in dry environments or during winter months when the air tends to be drier. The lack of moisture causes the nasal mucosa to become dry and cracked, leading to bleeding.
- Other Likely diagnoses
- Hypertension: High blood pressure can cause blood vessels in the nose to become fragile and prone to bleeding.
- Allergic rhinitis: Inflammation and irritation of the nasal passages due to allergies can lead to nose bleeds.
- Nasal trauma: Minor injuries to the nose, such as picking or blowing the nose too hard, can cause bleeding.
- Upper respiratory infections: Viral or bacterial infections can cause inflammation and bleeding in the nasal passages.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Nasopharyngeal cancer: Although rare, cancer in the nasopharynx can cause spontaneous nose bleeds and is critical to diagnose early.
- Granulomatosis with polyangiitis (formerly known as Wegener's granulomatosis): This is a rare autoimmune disorder that can cause inflammation of the blood vessels, leading to nose bleeds among other symptoms.
- Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome): A genetic disorder that leads to the formation of abnormal blood vessels, which can cause recurrent nose bleeds.
- Rare diagnoses
- Blood clotting disorders (e.g., hemophilia, von Willebrand disease): These conditions affect the blood's ability to clot, leading to an increased risk of bleeding, including nose bleeds.
- Arteriovenous malformations: Abnormal connections between arteries and veins can cause bleeding, including in the nose.
- Scurvy: A disease caused by vitamin C deficiency, which can lead to poor collagen synthesis and increased bleeding tendency, including nose bleeds.