Ozena and tinnitus

Q I have a long-standing problem with my nose, a disease called ozena. A foul odour fills the air when I go in among a crowd like in a church. It’s deeply embarrassing. I went to a nose specialist who could not find anything wrong. I am at the stage now where I will have to stop going out. It’s destroying my self-confidence.

A Ozena, otherwise known as atrophic rhinitis, was first diagnosed in the early 1800s, and is relatively uncommon today. One of the main clinical features of this disease is the accompanying odour. Other key symptoms include inflammation and atrophy of the mucosa of the nose, and a loss of smell. The thinning of the mucosa leads to a roominess in the nostrils along with crusting (which is the cause of the odour).

While it is unusual, it can run in families, so check out your family history if possible. Other common causes are hormonal — particularly during the onset of adolescence, pregnancy, or menopause — or a deficiency in vitamins A, D and iron. The bacteria Klebsiella ozaenae is usually found in the nasal area (hence the name, ozena/ozaena), although Proteus vulgaris or E. coli can also be present. If testing shows the presence of any of these bacteria, then a topical antibiotic is typically prescribed. The same goes for nutrient deficiencies — therapeutic supplementation using vitamins A, D and iron can help if this is indicated.