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Robert B. Baker, MD
Kaiser Permanente Bonita, Calif

JAMA. 1994;271(7):502.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—The Rational Clinical Examination entitled "Does This Patient Have Sinusitis?" by Williams and Simel¹ contained an excellent review of the physical signs found in acute sinusitis. However, no mention was made of the characteristic "bad breath" odor found in many patients with this disorder. While odors may also be attributable to poor local hygiene, foreign bodies in the nares, other infections, or simple mouth breathing, I have found this odor quite sensitive in detecting sinusitis. Barness² makes mention of it as does Green³ in his text. Indeed, many patients in my practice who have presented with a chief complaint of bad breath have had other characteristic findings of sinusitis as well as opacified sinuses on roentgenogram.

I feel that we should use all of our senses, including olfaction, as diagnostic aids. Olfaction is certainly cost-effective! . . . [Full Text PDF of this Article]

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