Urgent considerations

See Differentials for more details

Rarely, distorted taste or other taste dysfunction can be an early symptom of a significant or life-threatening condition, such as amyotrophic lateral sclerosis (ALS), multiple sclerosis, lung cancer, myasthenia gravis, or coronavirus disease 2019 (COVID-19).[11]​​​[34][35][13]​​ In neurologic disease, taste disorders are often associated with symptoms such as dysphasia, dysphonia, or dysarthria.[62] COVID-19 taste disorders are commonly accompanied by loss of the sense of smell.[63]

Particular attention should be given to patients presenting with other neurologic symptoms accompanying taste disorders. In these cases, cranial computed tomography (CT) or magnetic resonance imaging (MRI) scans should be carefully examined to formally exclude any unidentified central nervous system pathology (e.g., tumor, stroke, multiple sclerosis).[46]​​​

A sweet dysgeusia should prompt exclusion of any paraneoplasia (e.g., lung cancer, thymoma).[1][57] Serum electrolytes may reveal hyponatremia. In such cases, a chest x-ray and/or CT scan of the lungs should be ordered.

The clinical presentation of COVID-19 is typically with fever, cough, dyspnea, and/or fatigue. Patients may develop a severe viral pneumonia leading to potentially fatal acute respiratory distress syndrome. Patients with suspected COVID-19 infection should be immediately isolated from other patients. Local infection prevention and control procedures should be implemented. See Coronavirus disease 2019 (COVID-19).

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