Which is NOT a unilateral differential for epistaxis?

• A. GP Mycosis
• B. Ethmoid Hematoma
• C. Sinusitis
• D. Trauma

Answer: (A)

Unilateral epistaxis points to a local issue confined to one side of the nose rather than a systemic process. A systemic granulomatous disease, such as granulomatosis with polyangiitis (often referred to in older texts as GP mycosis), tends to involve multiple sites and usually presents with bilateral nasal involvement and other systemic symptoms, not a strictly unilateral bleed. Because of that, it isn’t a typical unilateral differential for epistaxis. In contrast, problems like an ethmoid hematoma, localized sinusitis, or trauma affect one side of the nasal cavity and can cause bleeding on that side. So the systemic condition is the not-unilateral option, while the others fit the unilateral pattern.