I'd appreciate some help with a patient... I apologize for the
somewhat thin information... this was a telephone consult, and I'm
trying to figure out what to advise her and her physician.
This is a middle-aged professional woman who began to experience the
sensation of "the hottest jalapeno pepper you could imagine" over the
entire ventral surface of her tongue about eight months ago. The
sensation is intermittent, usually absent in the mornings, and present
About two weeks ago she suddenly began to experience a metallic taste
Her family harvests their own shellfish and shrimp on the southern
coast of South Carolina, but no one else in the family has experienced
any similar symptoms.
She has had a negative dental exam, as well as referrals to ENTand
neurology; negative CT scan (checking CN VII and IX, I assume). Her
workup for pernicious anemia showed a mild anemia; no glossitis or
tenderness over the parotids or other salivary glands. A course of B12
had no effect. A screen for mercury was negative.