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Ozena, which is also called rhinitis sicca or atrophic rhinitis, is a rare disorder of the nasal passages. It occurs most often in arid regions such as India, Egypt and the Middle East as well as in many other developing nations. There was no cure for this disease as of 2011. Doctors manage the symptoms with antibiotics, nasal irrigation and surgery.
Patients who suffer from the condition usually lose their sense of smell. A greenish discharge collects inside the nasal passages, and large areas of crust fill the nasal cavity. These crusts often bleed if they are removed. The discharge has a highly unpleasant smell, and although the patient cannot detect the odor, he or she might suffer in social settings.
Inside the patient's nose, the nasal passages become inflamed, and the mucous membranes and bony ridges deteriorate. The small vessels inside the nose also become diseased. Sometimes holes form in the cartilage between the nostrils. The nasal discharge might also contain pus.
Untreated ozena might lead to social isolation. The smell can be so intense that friends and family refuse to associate with the patient. In severe situations, larval flies, called maggots, might infest the nose and can cause meningitis.
A doctor can diagnose the disease from the physical symptoms as well as from the patient's smell. Afterward, he or she labels it as either primary or secondary atrophic rhinitis. Primary ozena occurs when the patient becomes infected with bacteria such as Bacillus Mucosus or Klebsiella Ozaenae. Secondary forms of the disease are usually the result of radiation, nasal trauma or surgery.
People who live in severe poverty are at greater risk of contracting ozena than individuals from a higher socioeconomic status. Hormone imbalances, autoimmune diseases, vitamin deficiencies and poor nourishment may also contribute to the problem. Teenagers are also at higher risk than adults.
Medical practitioners usually address the symptoms, since the exact cause of ozena is often unknown. The doctor might prescribe nose drops containing glucose and glycerin to inhibit bacterial growth. Patients are also instructed to irrigate, or flood the nose, with solutions such as sodium chloride or sodium bicarbonate to loosen up the discharge and prevent bacteria from colonizing the damaged tissues.
Antibiotics are often prescribed in conjunction with other treatments. Patients must continue irrigating the nose several times a day after discontinuing antibiotic treatment. Irrigation must be practiced for the rest of the patient's life to prevent relapses from occurring.
The doctor might also recommend that the patient place mineral oil or glycerin inside the nose to keep the tissues from drying out. Some physicians also suggest adding an odor-control agent such as menthol. Severe cases might even require surgical intervention.
I once heard a missionary talk about the challenges of living in Third World conditions, and he mentioned ozena. He said he was sent to a village one time to minister to a church volunteer who had become really sick. He said when he walked into the boy's hut, he could smell a strong odor that made him sick for a minute. The boy was no longer allowed to attend school or church because the smell of the ozena was bothering other people.
The missionary said he went to a Western doctor at a nearby clinic and the doctor gave him a bottle of mentholated oil. It did make the smell more manageable, and the boy was able to resume his volunteer work at the church. The missionary said it wasn't an epidemic problem where he lived, but it was something most native populations knew about.
I'm surprised in this modern day and age, there still isn't a cure for a disease like ozena. I have to admit I hadn't heard of it until I read this article, but I think I've seen pictures of people who were suffering from it. I feel so sorry for anyone who has to live with a disease that can cause social ostracism like this one.