- 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.
- Any change in the subjective perception of taste including decreased, absence, or altered taste.
- Drugs, including chemotherapeutic agents
- Zinc deficiency
- Oral infections
- Upper respiratory infections (including COVID-19)
- Stroke involving the pons, thalamus, and midbrain
- Xerostomia (possibly secondary to Sjogren's)
- Intrinsic taste bud dysfunction
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 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
- Typically a clinical diagnosis
- Management should focus on treating the underlying cause, if one is identified.
- Outpatient ENT referral and workup
- 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.