Abstract
We report a case of cacogeusia, specifically metallogeusia (a perceived metallic or bitter taste) following pine nut ingestion. A 36-year-old male presented with cacogeusia one day following ingestion of 10–15 roasted pine nuts (genus: Pinus). Symptoms became worst on post-exposure day 2 and progressively improved without treatment over 5 days. There were no other symptoms and physical examination was unrevealing. All symptoms resolved without sequalae. We contemporaneously report a rise in pine nut-associated cacogeusia reported online during the first quarter of 2009, and a significant rise in online searches related to pine nut-associated cacogeusia (or what the online public has termed “pine mouth”) during this time. Most online contributors note a similar cacogeusia 1-3 days following pine nut ingestion lasting for up to 2 weeks. All cases seem self-limited. Patients occasionally describe abdominal cramping and nausea after eating the nuts. Raw, cooked, and processed nuts (in pesto, for example) are implicated. While there appears to be an association between pine nut ingestion and cacogeusia, little is known about this condition, nor can any specific mechanism of specific cause be identified. It is not known if a specific species of pine nut can be implicated. “Pine mouth” appears to be an emerging problem.
Keywords: Cacogeusia, Dysgeusia, Metallogeusia, Pinus
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Acknowledgments
Conflicts of Interest
None declared.
Footnotes
No funding was received
References
- 1.Heckmann JG, Lang CJ. Neurological causes of taste disorders. Adv Otorhinolaryngol. 2006;63:255–264. doi: 10.1159/000093764. [DOI] [PubMed] [Google Scholar]
- 2.Chiang WK. Otolaryngologic principles. In: Flomenbaum NE, Goldfrank LR, Hoffman RS, Howland MA, Lewin NA, Nelson LS, editors. Goldfrank's toxicologic emergencies. 8. New York: McGraw-Hill; 2006. [Google Scholar]
- 3.Ackerman BH, Kasbekar N. Disturbances of taste and smell induced by drugs. Pharmacotherapy. 1997;17(3):482–496. [PubMed] [Google Scholar]
- 4.Henkin RI. Drug-induced taste and smell disorders. Incidence, mechanisms and management related primarily to treatment of sensory receptor dysfunction. Drug Saf. 1994;11(5):318–377. doi: 10.2165/00002018-199411050-00004. [DOI] [PubMed] [Google Scholar]
- 5.Mostin M. Taste disturbances after pine nut ingestion (abstract) Eur J Emerg Med. 2001;8(1):76. [Google Scholar]
- 6.The last word: transient taste. 2008 [updated 2008]. Available from http://www.newscientist.com/blog/lastword/2008/08/transient-taste.html. Accessed 18 May 2009
- 7.Bitter taste in mouth while eating. 2008 [updated 2008] Available from http://www.steadyhealth.com/Bitter_taste_in_mouth_while_eating-t85978-0-asc-90.html. Accessed 18 May 2009
- 8.The great pine nut mystery. 2009 [updated 2009]. Available from: http://lukehoney.typepad.com/the_greasy_spoon/2009/02/the-great-pine-nut-mystery.html. Accessed 18 May 2009
- 9.Pine nuts left a bitter taste in my mouth. 2009 [updated 2009]. Available from http://pinchmysalt.com/2009/05/02/pine-nuts-left-a-bitter-taste-in-my-mouth/. Accessed 18 May 2009
- 10.Middleton C. Pine mouth puzzle: why do these nuts leave you with a bitter taste? The Daily Mail. 18 May 2009
- 11.Ginsberg J, Mohebbi MH, Patel RS, Brammer L, Smolinski MS, Brilliant L. Detecting influenza epidemics using search engine query data [letter] Nature. 2009;457:1012–1014. doi: 10.1038/nature07634. [DOI] [PubMed] [Google Scholar]
- 12.Google.org. Flu Trends. How does this work? 2009 [updated 2009]. Available from http://www.google.org/about/flutrends/how.html. Accessed 18 June 2009
- 13.Google. About Google Trends. 2009 [updated 2009]. Available from http://www.google.com/intl/en/trends/about.html. Accessed 18 June 2009
- 14.Miraliakbari H, Shahidi F. Oxidative stability of tree nut oils. J Agric Food Chem. 2008;56(12):4751–4759. doi: 10.1021/jf8000982. [DOI] [PubMed] [Google Scholar]