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Saturday, February 26, 2011

Weekend Case: A 3.5-year-old boy presents with snorting and sniffing, and has been congested and plugged up

A 3.5-year-old boy presents with his mother as a new patient to your practice. His mother describes that he has been snorting and sniffing, and has been congested and plugged up for a few months. The patient intake form that his mother completed before the visit notes that the symptoms might have started 6-8 months ago, although she does not remember any specific starting date. She thinks that the symptoms worsen when they visit her in-laws on the farm and friends who have cats. He has had 2 ear infections in the past 4 months. She does not report him having any wheezing or coughing. His immunizations are all up-to-date, and he has never had any surgeries or hospitalizations. He is the product of a normal full-term pregnancy and delivery.

Q1. In physical finding the picture below is seen. What are those lines beneath his lower eyelids?

Q2. What is your diagnosis?



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