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BACKGROUND: Rhinoliths are calcified masses formed in the nasal cavity by the deposit of mineral salts. The nest of a rhinolith is usually an exogenous foreign body forgotten in the nose during childhood (seeds, beads, cotton and insects). CLINICAL CASE: A 32-year-old male patient with chronic kidney disease. We were consulted as part of the protocol for the patient’s kidney transplant. Upon questioning, the patient began his current condition 12 years ago with left nasal obstruction, with no apparent triggering cause, accompanied by anterior and posterior left nasal discharge with mucopurulent, fetid characteristics, in moderate amount, with exacerbations and partial remissions to medical treatment with multiple antibiotic regimens at unspecified doses and durations. CONCLUSIONS: Because it is a rare entity, the diagnosis of a rhinolith must have a high clinical suspicion, directing the questioning to the patient and accompanying it with imaging studies; simple computed tomography is the study of choice. Treatment must be surgical, with complete resection of the foreign body, and resolution of the complications that it has generated. [ABSTRACT FROM AUTHOR]

Background: The SARS-CoV-2 pandemic continues to be a priority health problem; According to the World Health Organization data from October 13, 2020, 37,704,153 confirmed COVID-19 cases have been reported, including 1,079,029 deaths, since the outbreak. The identification of potential symptoms has been reported to be a useful tool for clinical decision-making in emergency departments to avoid overload and improve the quality of care. The aim of this study was to evaluate the performances of symptoms as a diagnostic tool for SARS -CoV-2 infection.Methods: An observational, cross-sectional, prospective and analytical study was carried out, during the period of time from April 14 to July 21, 2020. Data (demographic variables, medical history, respiratory and non-respiratory symptoms) were collected by emergency physicians. The diagnosis of COVID-19 was made using SARS-CoV-2 RT-PCR. The diagnostic accuracy of these characteristics for COVID-19 was evaluated by calculating the positive and negative likelihood ratios. A Mantel-Haenszel and multivariate logistic regression analysis was performed to assess the association of symptoms with COVID-19.Results: A prevalence of 53.72% of SARS-CoV-2 infection was observed. The symptom with the highest sensitivity was cough 71%, and a specificity of 52.68%. The symptomatological scale, constructed from 6 symptoms, obtained a sensitivity of 83.45% and a specificity of 32.86%, taking ≥2 symptoms as a cut-off point. The symptoms with the greatest association with SARS-CoV-2 were: anosmia odds ratio (OR) 3.2 (95% CI; 2.52-4.17), fever OR 2.98 (95% CI; 2.47-3.58), dyspnea OR 2.9 (95% CI; 2.39-3.51]) and cough OR 2.73 (95% CI: 2.27-3.28).Conclusion: The combination of ≥2 symptoms / signs (fever, cough, anosmia, dyspnea and oxygen saturation < 93%, and headache) results in a highly sensitivity model for a quick and accurate diagnosis of COVID-19, and should be used in the absence of ancillary diagnostic studies. Symptomatology, alone and in combination, may be an appropriate strategy to use in the emergency department to guide the behaviors to respond to the disease.Trial Registration: Institutional registration R-2020-3601-145, Federal Commission for the Protection against Sanitary Risks 17 CI-09-015-034, National Bioethics Commission: 09 CEI-023-2017082 . [ABSTRACT FROM AUTHOR]

In late 2019, it was identified a new coronavirus called SARS-CoV-2 as the cause of an outbreak of acute respiratory disease in Wuhan (China), later named COVID-19 by the World Health Organization, declaring it in March 2020 as a pandemic. It has been reported that 5.1%-98% of COVID-19 patients present alterations in taste and smell, even manifested before all symptoms, which implies the great importance of recognizing these alterations as a biomarker of the disease. Three routes of invasion of SARS-CoV-2 into the nervous system have been proposed: 1) the hematogenous route, 2) the direct route and 3) the retrograde axonal transport to the central nervous system. To date, none of the pharmacological treatments proposed of smell and taste disorders have sufficient scientific evidence to support their prescription. Regarding the prognosis of changes in taste and smell, the recovery is complete in a span of 0-30 days; while in the first 8 days an improvement of 27% to 31.9% after resolution of general symptoms is reported. [ABSTRACT FROM AUTHOR]