Dysgeusia

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

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.