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Una mujer de 40 años acude a la clínica con un historial de empeoramiento de la congestión nasal e infecciones sinusales recurrentes. Había estado sana hasta aproximadamente 1 año, cuando notó por primera vez la rinorrea persistente, los estornudos y la congestión. Señaló que cuando se fue de vacaciones durante dos semanas a México, su rinorrea desapareció, sólo para regresar cuando volvió a casa. La paciente ha vivido en la misma casa durante los últimos 5 años, junto con su esposo y un hijo. Han tenido un perro por 4 años y un gato por 1 año. En el examen físico, tiene cornetes nasales hinchados y abotagados y una apariencia adoquinada en su faringe posterior.

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