What Causes Nosebleeds?

Patient Presentation A 7-month-old male living in the upper-Midwest came to clinic in January after his mother found several spots of dried blood the size of a nickel on his sheets and dried blood on his nose when he awoke in the morning. He had a great deal of clear-yellowish rhinorrhea for 3 days. He was afebrile and was having some problems breast-feeding because of the rhinorrhea. His mother was using saline and bulb-suction frequently to clear his nose. She also was using a humidifier near his bed. He was otherwise well. The past medical history and review of systems were negative. The pertinent physical exam revealed an infant with obvious copious mucopurulent discharge from his nose. His vital signs and growth parameters were normal. He had increased tearing of his eyes. Tympanic membranes were grey with splayed light reflexes and normal mobility. His mouth was negative. His nose showed a small amount of dried blood around the entrance to the right nares. He had marked ...  more