A 10-year-old boy visited his doctor with his mother in the spring. His current symptoms of rhinorrhoea, nasal congestion, sneezing and itching eyes were interfering with his schoolwork. He gave a...

A 10-year-old boy visited his doctor with his mother in the spring. His current symptoms of rhinorrhoea, nasal congestion, sneezing and itching eyes were interfering with his schoolwork. He gave a history of repeated episodes of recurrent otitis media, rhinorrhoea, nasal congestion, sneezing and itching eyes occurring over a 3-year period but predominantly in the spring and autumn. He had had three episodes of otitis media over the previous 2 years, the last being 6 months before, which were treated with antibiotics because of prolonged residence of fluid in the middle ear. The boy had atopic dermatitis as an infant. He had no history of asthma; his mother had allergic rhinitis; they had two cats. Other than antibacterial drug treatment for his otitis media, he had taken no medication. Examination of the ears revealed healthy tympanic membranes with no current otitis media. He had no hearing loss and was otherwise fit.

1. What was the likely diagnosis?

2. Were the boy’s symptoms related to the history of otitis media?

3. Allergen skin testing showed him to be responsive to cat dander and house dust mites. What treatment would you give?