Primary atrophic rhinitis (called ozena, meaning "stench") is a chronic condition of unknown cause.


Clinical features:

(1) chronic, bilateral rhinitis

(2) atrophy of the nasal mucosa and turbinates, with enlargement of the nasal passages

(3) presence of a foul-smelling mucopurulent discharge

(4) widespread crusting as the discharge dries out

(5) often concommitant paranasal sinusitis

(6) choking sensation if lesions extend into the nasopharynx


Risk factors:

(1) poor social conditions

(2) female gender

(3) after puberty


Possible contributory causes:

(1) infection with Klebsiella ozaenae or other bacteria

(2) endocrine imbalance

(3) autoimmune disease


Differential diagnosis - atrophic sinusitis secondary to another cause:

(1) radiation therapy

(2) excessive surgery or trauma

(3) chronic granulomatous inflammation


To read more or access our algorithms and calculators, please log in or register.