Diagnosing patients through the sense of smell

In the 18th century, doctors could make diagnoses of kidney failure, diabetes and liver disease by smelling a patient. However, doctors today do not regularly use their noses. Here is a modern day example of how the sense of smell can be used to diagnose patients.

A 50-year-old woman was admitted to the hospital with complaints of severe weakness and difficulty breathing. On examination this one was sweaty and had pinpoint pupils, and her lungs were wheezy… For this woman, the diagnosis remained obscure for the next hour as her breathing got more labored and she became comatose.

Then an experienced nurse, with a good sense of smell, came to the rescue. The nurse noted that the patient had a peculiar odor, resembling garlic, most prominently from her hair. The unusual odor raised the suspicion of insecticide poisoning with organophosphates.

The patient was immediately treated with atropine and 2-PAM to reverse the effects of the poison… Each time she received the medications she woke and improved, but then lapsed back into a coma with increasing lung problems.

Since the primary contamination seemed to be in her hair, her head was shaved. After that she improved rapidly, her medicines were tapered and she regained consciousness. Soon she was able to breathe on her own.

Link & Image: New York Times
Tags: Smell | Patient | Doctor | Poisoning