1/20. Psychiatric patients presenting with primarily somatic symptoms: report of two cases. Two recent cases of psychiatric disorders, presenting primarily with physical symptoms are described, which suggest that both psychotic and psychoneurotic disorders can present with somatic symptoms for which no adequate physical cause could be defined. It is emphasised that such cases require specialist psychiatric evaluation and assessment for the appropriate management to be initiated. Recent studies have stressed the frequency with which psychiatric illness or psychological distress is presented in most African patients as somatic illness, especially in depressive illness, psychotic disorders and psychoneurotic disorders (1). Two such cases of different diagnoses are presented here. ( info) |
| subphrenic abscess is a recognised complication of splenectomy, but fistulation into the stomach is extremely rare. This report describes a delayed complication of splenectomy presenting as offensive and socially disabling halitosis. ( info) |
3/20. Successful treatment of gut-caused halitosis with a suspension of living non-pathogenic escherichia coli bacteria--a case report. In up to 90% of cases, severe halitosis is a result of gastrointestinal or orolaryngeal problems. This case study reports on a girl with bad breath caused by increased formation of malodorous intestinal gases (halitosis), which could be successfully treated with a suspension of living non-pathogenic bacteria escherichia coli. Conclusion: in unclear cases of bad breath, an increased formation of intestinal gases should also be considered. ( info) |
4/20. Somatoform salivary complaints. case reports. patients with salivary gland complaints are seen with a large array of signs and symptoms. Usually these patients have an underlying pathophysiological process that can account for their symptoms. However, in a significant number of patients, no known biological process can be found that would account for the patient's complaint. In such cases, somatization is a possible cause. Somatization is a frequently cited feature of patients with various forms of mental illness. In this paper, we will attempt to illustrate the classic signs of a somatoform disorder in three different patients whose diverse salivary complaints fulfill the criteria for a diagnosis of somatoform disease. ( info) |
5/20. "Bad breath": presenting manifestation of anaerobic pulmonary infection. Three patients are described in whom a putrid breath odor was the only or fist manifestation of anaerobic infection of the lung. fever, productive cough, and pleuritic pain, common findings in anaerobic pulmonary infection, were not initally present. "Bad breath" may be an early due to the presence of anaerobic pulmonary infection. ( info) |
6/20. Pharyngeal foreign body in a child persisting for three years. Foreign body ingestions are common in children. They can pose a diagnostic problem if the foreign body is embedded in the soft tissues of pharynx. A 4 year old girl presented with halitosis for two years. A pharyngeal foreign body, a metallic ring, was seen on lateral radiographs of the neck. The foreign body was removed under general anaesthesia. A completely embedded pharyngeal foreign body should be considered in cases presenting with halitosis. ( info) |
7/20. Breath malodor in an asthmatic patient caused by side-effects of medication: a case report and review of the literature. OBJECTIVE: The purpose of this report is to document the presence of dimethyl sulfide in mouth air as the predominant volatile sulfur compound (VSC) in an asthmatic patient who was regularly taking suplatast tosilate. STUDY DESIGN: The patient was a 33-year-old woman who complained of bad breath. She had been diagnosed as having asthma and was receiving periodical medical examinations once a month. VSC in her mouth air were measured with a gas chromatograph. Oral physiotherapy was also carried out to remove any oral malodor of which the source was intraoral. RESULTS: With the improvement in oral hygiene and periodontal conditions, the level of VSC was reduced but dimethyl sulfide still remained as the predominant VSC. CONCLUSIONS: Dimethyl sulfide metabolized from suplatast tosilate may be a potential cause of halitosis. ( info) |
8/20. Olfactory reference syndrome: diagnostic criteria and differential diagnosis. Olfactory reference syndrome (ORS) has been defined as a psychiatric condition characterized by persistent preoccupation about body odour accompanied by shame, embarrassment, significant distress, avoidance behaviour and social isolation. ORS has however not been included in the diagnostic and statistical manual of mental disorders (4th edition) (DSM-IV) and, given that its primary symptoms may be found in various other disorders, differential diagnosis can be problematic. Using an illustrative case of ORS, we propose diagnostic criteria for ORS. We also argue that ORS represents a unique cluster of symptoms that can be delineated as a separate diagnostic entity, and that ORS falls on a spectrum of social anxiety disorders that includes social anxiety disorder, taijin kyofusho, and body dysmorphic disorder. ( info) |
| The exact pathophysiological mechanism of halitosis is not clear, and in many patients the etiology is an enigma. We followed three couples in which one member or both had halitosis. All the subjects had evidence of helicobacter pylori infection. All received a treatment course of colloidal bismuth subcitrate four times a day and 250 mg metronidazole three times a day. There was impressive improvement in their symptoms, the halitosis disappearing along with eradication of the organism. We call the attention of physicians to the possible connection between halitosis, H. pylori infection, and familial occurrence. Further studies to confirm this surprising association are in order. ( info) |
10/20. Tonsillolith as a halitosis-inducing factor. halitosis, or bad breath, is a common concern for many people. The main causes are known to be periodontal disease and tongue coating. We present a case of an incidental tonsillolith occurrence, which was a halitosis-inducing factor. Our results show that tonsilloliths should be considered as a possible cause of halitosis. ( info) |