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Fish-odor syndrome presenting as dysosmia.
D A Leopold1, G Preti, M M Mozell
1Department of Otolaryngology, State University of New York, Syracuse 13210.
Archives of Otolaryngology--Head & Neck Surgery
|March 1, 1990
Summary
A patient experienced a persistent fish-like odor for 20 years. This was eventually diagnosed as trimethylaminuria, a treatable metabolic disorder, highlighting the importance of considering metabolic causes for olfactory complaints.
Area of Science:
- Otolaryngology
- Metabolic Disorders
- Chemosensory Science
Background:
- Persistent olfactory complaints can be challenging to diagnose.
- Previous treatments for infections, inflammation, and psychiatric disorders were unsuccessful for this patient.
- A 20-year history of perceived unpleasant odor prompted specialized olfactory evaluation.
Observation:
- The perceived odor occurred only during exhalation and appeared binasal.
- Endoscopic examination of the nose, pharynx, and lungs, along with taste and olfactory testing, were performed.
- A morning mucus sample exhibited a strong, fish-like odor.
Findings:
- Specialized chemosensory testing confirmed the patient had trimethylaminuria.
- Trimethylaminuria is a metabolic disorder characterized by the inability to break down trimethylamine.
- The fish-like odor is a characteristic symptom of trimethylaminuria.
Implications:
- This case underscores the importance of considering metabolic disorders in patients with chronic olfactory complaints.
- Early diagnosis of trimethylaminuria can lead to effective management and symptom improvement.
- Broadening the differential diagnosis for olfactory dysfunction to include metabolic conditions is crucial for patient care.