Cerebrospinal fluid rhinorrhea: an allergist's perspective

Perplexing cases of profuse rhinorrhea may be referred for allergy evaluation as reported in three patients ultimately found to have cerebrospinal fluid rhinorrhea. Physicians should be alert to this possibility when confronted with patients needing towels to collect nasal discharge, or whose handkerchiefs are limp upon drying. Coughing and choking at night are common. Patients should be asked to lie face down during the course of physical examination, as rate of flow often increases greatly in this position.