Considerations
Some medical disorders will produce specific, characteristic odors to the breath.
* A fruity odor to the breath occurs as the body attempts to get rid of excess acetone through the breathing. This is a characteristic sign of ketoacidosis (such as diabetic ketoacidosis), a potentially life-threatening condition.
* A fecal odor to the breath (the breath smells like feces) can occur with prolonged vomiting, especially when there is a bowel obstruction. It can also occur temporarily if the person has a nasogastric tube in place (a tube placed through the nose or mouth to the stomach to drain the stomach contents).
* The breath may have an ammonia-like odor (also described as urine-like or "fishy") in people with chronic kidney failure.
Common Causes
If previously normal breath turns into halitosis, causes could include:
* tonsils
* Food or beverages consumed (such as cabbage, garlic, raw onions,
alcoholic drinks, or coffee)
* Vitamin supplements (especially in large doses)
* Poor dental hygiene
* Dentures
* Cavities
* Tobacco smoking
* Alcoholism
* Throat infection
* Sinusitis
* Lung infection
* Gum disease (gingivitis, gingivostomatitis)
* Abscessed tooth
* Impacted tooth
* Foreign body in the nose (in children)
o Often (but not always) there is a white, yellowish, or bloody discharge
from one nostril
* Drugs
* Paraldehyde
* Triamterene and inhaled anesthetics
* Insulin - injection
Diseases that may be associated with breath odor (not presented in order of likelihood—some are extremely unlikely):
* Acute necrotizing ulcerative gingivitis
* Acute necrotizing ulcerative mucositis
* Acute renal failure
* Bowel obstruction (can cause breath to smell like feces)
* Bronchiectasis
* Chronic renal failure (can cause breath to smell like ammonia)
* Diabetes (fruity or "sweet chemical" smell with ketoacidosis)
* Esophageal cancer
* Gastric carcinoma
* Gastrojejunocolic fistula (fruity-smelling breath)
* Hepatic encephalopathy
* Diabetic ketoacidosis
* Lung abscess
* Ozena, or atrophic rhinitis
* Periodontal disease
* Pharyngitis
* Zenker's diverticulum