Symptoms include easy bruising, urinary tract bleeding (hematuria), nosebleeds (epistaxis), and bleeding into joints (hemarthrosis). Some patients have spontaneous mucosal bleeding, such as menorrhagia, epistaxis, and gum bleeding. Hematemesis, melena, hemoptysis, hematuria and epistaxis also occur and may lead to hypovolemic shock. Bleeding tendency may be observed in epistaxis and purpura. Rhinoliths can cause nasal obstruction, epistaxis, headache, sinusitis and epiphora. Burning sensation while instilling, numbness, erythema, facial flushing, headache, epistaxis, and nausea have been reported. In the maxilla it can cause proptosis, epistaxis and nasal airway obstruction. Epistaxis and pain may occur due to the ulceration of surrounding mucosa. Diagnosis can be suspected in case of respiratory infection associated with splenomegaly and/or epistaxis. Removal is important in preventing nasal obstruction and recurrent epistaxis. It may cause clinically significant bleeding, especially epistaxis. It is characterized by a fever, chills, nausea, headaches, malaise and epistaxis. Posterior nasal packing is needed for posterior epistaxis. It is sometimes done as well to cure recurrent nosebleed (epistaxis) due to septal spur. A nosebleed, also known as epistaxis, is bleeding from the nose.