08-26-2010, 03:07 PM
A 9-year-old Caucasian boy is brought to your office with a two-month history of periodic clear rhinorrhea, nasal and orbital itching, and dry cough. His mother notes that the symptoms usually appear after the child plays with a neighbor's dog. His past medical history is significant for an episode of severe pneumonia experienced two years ago. Physical examination reveals excoriations of the external nares. The lungs are clear on auscultation. Which of the following is the next best step in the management of this patient?
Options
1. Avoidance of the dog
2. Nasal decongestant sprays
3. Nasal corticosteroids
4. Second-generation antihistamines
5. Cromolyn sodium
Options
1. Avoidance of the dog
2. Nasal decongestant sprays
3. Nasal corticosteroids
4. Second-generation antihistamines
5. Cromolyn sodium