Dysgeusia: Difference between revisions
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
* Drugs, including chemotherapeutic agents | * Drugs, including chemotherapeutic agents | ||
* Zinc deficiency | * [[Zinc deficiency]] | ||
* Oral infections | * [[Oral infections]] | ||
* Upper respiratory infections (including COVID-19) | * Upper respiratory infections (including [[COVID-19]]) | ||
* Diabetes | * [[Diabetes]] | ||
* | * [[Stroke]] involving the pons, thalamus, and midbrain | ||
* Xerostomia (possibly secondary to Sjogren's) | * Xerostomia (possibly secondary to Sjogren's) | ||
* Intrinsic taste bud dysfunction | * Intrinsic taste bud dysfunction | ||
* Hypothyroidism | * [[Hypothyroidism]] | ||
* GERD | * [[GERD]] | ||
* Pregnancy | * [[Pregnancy]] | ||
==Evaluation== | ==Evaluation== | ||
Evaluation of dysgeusia is difficult as it involves a complex interplay of the somatosensory system, the sense of smell, and the sense of pain. | ''Evaluation of dysgeusia is difficult as it involves a complex interplay of the somatosensory system, the sense of smell, and the sense of pain.'' | ||
* At a minimum, evaluation should include a complete and thorough physical exam of the tongue and oropharynx | * At a minimum, evaluation should include a complete and thorough physical exam of the tongue and oropharynx | ||
===Workup=== | ===Workup=== | ||
Workup should focus on ruling out secondary causes. Questions should be asked regarding oral health, salivation, prior and/or current upper respiratory infections (including COVID-19) | ''Workup should focus on ruling out secondary causes. Questions should be asked regarding oral health, salivation, prior and/or current upper respiratory infections (including COVID-19)'' | ||
* Consideration of ruling out potential secondary causes such as cancer, DM, hypothyroidism, or oropharyngeal causes | |||
===Diagnosis=== | ===Diagnosis=== | ||
*Typically a clinical diagnosis | |||
==Management== | ==Management== | ||
Management should focus on treating the underlying cause, if one is identified. | *Management should focus on treating the underlying cause, if one is identified. | ||
==Disposition== | ==Disposition== | ||
Outpatient ENT referral and workup | *Outpatient ENT referral and workup | ||
==See Also== | ==See Also== | ||
| Line 40: | Line 42: | ||
==References== | ==References== | ||
<references/> | <references/> | ||
*NEJM: Taste and Smell in Disease. | |||
*JAMA: Smell and Taste Disorders, A Study of 750 Patients From the University of Pennsylvania Smell and Taste Center. | |||
[[Category:Neurology]] | |||
Latest revision as of 02:06, 27 November 2021
Background
- Dysgeusia (also known as parageusia) refers to alteration in the sense of taste. This includes ageusia (lack of sense of taste) and hypogeusia (decrease in sense of taste).
- Can be primary or secondary in nature.
Clinical Features
- Any change in the subjective perception of taste including decreased, absence, or altered taste.
Differential Diagnosis
- Drugs, including chemotherapeutic agents
- Zinc deficiency
- Oral infections
- Upper respiratory infections (including COVID-19)
- Diabetes
- Stroke involving the pons, thalamus, and midbrain
- Xerostomia (possibly secondary to Sjogren's)
- Intrinsic taste bud dysfunction
- Hypothyroidism
- GERD
- Pregnancy
Evaluation
Evaluation of dysgeusia is difficult as it involves a complex interplay of the somatosensory system, the sense of smell, and the sense of pain.
- At a minimum, evaluation should include a complete and thorough physical exam of the tongue and oropharynx
Workup
Workup should focus on ruling out secondary causes. Questions should be asked regarding oral health, salivation, prior and/or current upper respiratory infections (including COVID-19)
- Consideration of ruling out potential secondary causes such as cancer, DM, hypothyroidism, or oropharyngeal causes
Diagnosis
- Typically a clinical diagnosis
Management
- Management should focus on treating the underlying cause, if one is identified.
Disposition
- Outpatient ENT referral and workup
See Also
External Links
References
- NEJM: Taste and Smell in Disease.
- JAMA: Smell and Taste Disorders, A Study of 750 Patients From the University of Pennsylvania Smell and Taste Center.
