Differential diagnosis of cacosmia and dysgeusia in COVID-19 pandemic. Clinical case report

Abstract

Olfactory and gustatory dysfunctions were presented in a high percentage of COVID-19 cases. Most of them are represented by quantitative disorders. Qualitative alterations were established in a small proportion. During the Covid-19 pandemic, there is a need to make a differential diagnosis (DD) of olfactory and gustatory disorders. Clinical case of a 64-year-old man presented with dairy food cacosmia and dysgeusia for the last two weeks, and night sweats. From medical history we found that our patient recovered from COVID-19 infection, one month ago. Based on some studies, patients with COVID-19 infection, presented moderate to severe olfactory or gustatory dysfunctions for long-term, in convalescent period. It’s important to make a DD of smell and taste impairements and choose the necessary treatment. Esophageal candidiasis was diagnosed in our patient. After 21 days of antifungal treatment cacosmia and dysgeusia disappeared. HIV test was negative. Some studies presented that COVID-19 infection is linked with a continuous reduction in lymphocytes along the disease. We hypothesized that immunodeficiency in COVID-19 infection and antibiotic therapy could be the trigger for esophageal candidiasis in our case. Our case report highlighted the importance of smell and taste disorders DD, in COVID-19 pandemic. Dairy food cacosmia and dysgeusia can be a sign of esophageal candidiasis. That's why, convalescent COVID-19 infection patients should be monitored for a long-term period.