Bad Breath (Halitosis): Or something else? Differential Diagnosis

Respiratory System (J00-J99)

  • Bronchiectasis (synonym: bronchiectasis)-permanent irreversible saccular or cylindrical dilatation of the bronchi (medium-sized airways) that may be congenital or acquired; symptoms: chronic cough with “mouthful expectoration” (large-volume triple-layered sputum: foam, mucus, and pus), fatigue, weight loss, and decreased exercise capacity
  • Lung abscess – encapsulated accumulation of pus in the lungs.
  • Pneumonia (pneumonia)
  • Sinusitis (sinusitis)
  • Tonsil stones (tonsil stones, tonsilloliths).

Endocrine, nutritional and metabolic diseases (E00-E90).

  • Coma diabeticum – comatose state due to hyperglycemia (high blood sugar) in diabetes mellitus.
  • Malnutrition / undernutrition
  • Trimethylaminuria (fish odor syndrome) – genetic disorder.

Skin and subcutaneous (L00-L99).

  • Pemphigus – refers to severe skin diseases associated with blistering.

Infectious and parasitic diseases (A00-B99).

  • Angina Plaut-Vincenti – relatively rare form of tonsillitis (tonsillitis). It is the best-known form of the so-called fusotreponematoses, which can also occur outside the tonsils (tonsils) on the pharyngeal mucosa and gums
  • Diphtheria (true croup) – infectious disease caused by infection of the upper respiratory tract with Gram-positive Corynebacterium diphtheriae.
  • Gingivostomatitis herpetica – inflammation of the gums, which has spread to the entire oral mucosa.
  • Mononucleosis (Pfeiffer’s glandular fever) – common viral disease (Epstein-Barr virus (EBV)), with benign disease of the lymphoid tissue.

Liver, gallbladder and bile ducts – pancreas (pancreas) (K70-K77; K80-K87).

  • Hepatic insufficiency/dysfunction of the liver with partial or complete failure of its metabolic functions (foetor hepaticus: intense, sweetish, and slightly fetid (“putrid”) odor reminiscent of fresh liver or even feces (feces)).

Mouth, esophagus (food pipe), stomach, and intestines (K00-K67; K90-K93).

  • Acute gingivitis (inflammation of the gums).
  • Acute necrotizing ulcerative gingivitis – severe gingivitis leading to the formation of ulcers.
  • Gastroesophageal reflux disease (synonyms: GERD, gastroesophageal reflux disease; gastroesophageal reflux disease (GERD); gastroesophageal reflux disease (reflux disease); gastroesophageal reflux; reflux esophagitis; reflux disease; Reflux esophagitis; peptic esophagitis) – inflammatory disease of the esophagus (esophagitis) caused by the pathological reflux (reflux) of acid gastric juice and other gastric contents.
  • Caries
  • Laryngopharyngeal reflux (LRP) – “silent reflux” in which the cardinal symptoms of gastroesophageal reflux, such as heartburn and regurgitation (backflow of food pulp from the esophagus into the mouth), are absent.
  • Oral abscesses – encapsulated collections of pus in the oral cavity.
  • Esophageal achalasia – dysfunction of the lower esophageal sphincter (esophageal muscles), with the inability to relax; it is a neurodegenerative disease in which nerve cells of the myenteric plexus die. In the final stage of the disease, the contractility of the esophageal muscles is irreversibly damaged, with the result that food particles are no longer transported into the stomach and lead to pulmonary dysfunction by passing into the trachea (windpipe). Up to 50% of patients suffer from pulmonary (“lung“) dysfunction as a result of chronic microaspiration (ingestion of small amounts of material, e.g., food particles, into the lungs). Typical symptoms of achalasia are: Dysphagia (dysphagia), regurgitation (regurgitation of food), cough, gastroesophageal reflux (reflux of gastric acid into the esophagus), dyspnea (shortness of breath), chest pain (chest pain), and weight loss; as secondary achalasia, it is usually the result of neoplasia (malignant neoplasm), e.g., cardiac carcinoma (cancer of the entrance of the stomach).
  • Esophageal diverticula – bulges in the muscular layer of the esophagus, in which esophageal debris can accumulate.
  • Periodontitis – inflammation of the periodontium (periodontium).
  • Stomatitis (inflammation of the oral mucosa)
  • Xerostomia – dry oral mucosa
  • Tongue coating

Neoplasms – tumor diseases (C00-D48)

  • Gastric carcinoma (stomach cancer)

Psyche – nervous system (F00-F99; G00-G99)

  • Halitophobia – sign of psychiatric disorders in which the patient has a fear of bad breath.
  • Pseudohalitosis – sign of psychiatric disorders in which the bad breath is perceived only by the affected person.

Symptoms and abnormal clinical and laboratory findings not elsewhere classified (R00-R99).

  • Cough (for productive cough or sputum/sputum).
  • Cachexia (emaciation)
  • Rhonchopathy (snoring)

Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99).

  • Renal insufficiency (kidney weakness).

Injuries, poisoning, and other consequences of external causes (S00-T98).

  • Foreign body in the mouth/throat

Further

  • Alcohol abuse (alcohol dependence)
  • Improperly fitted prostheses
  • Fasting cure especially under weight reduction with a diet high in protein and fat) or “starvation”.
  • Poor dental hygiene
  • Heavy smokers

Medication

  • Dimethyl sulfoxide (DMSO) – active substance from the group of anti-inflammatory drugs used for the external treatment of pain, inflammation and swelling.
  • Disufiram (alcohol withdrawal medication).