fetor

Fetor is a medical term for a strong, unpleasant odor that arises from disease or metabolic disturbance. The word comes from the Latin fetor, meaning odor or stink, and is used to describe specific troublesome smells in clinical contexts rather than a general condition.

Common uses of the term include fetor oris, fetor hepaticus, and ureic or fetor uraemicus. Fetor oris refers to foul breath of oral origin, often related to dental disease, periodontal infection, dry mouth, or poor hygiene. Fetor hepaticus is a distinctive musty or sweet odor on the breath seen in advanced liver disease, especially cirrhosis, and is related to portosystemic shunting and the accumulation of volatile sulfur compounds. Ureic fetor, or fetor uraemicus, describes a foul breath associated with advanced kidney failure due to the buildup of uremic waste products such as ammonia.

Causes and mechanisms of fetor vary. They typically result from bacterial metabolism of degraded tissue or excreted waste products that release volatile compounds, including sulfur-containing compounds like dimethyl sulfide and mercaptans. In hepatic failure, diminished liver clearance and shunted blood pathways alter toxin profiles, producing the characteristic fetor hepaticus. In kidney failure, reduced clearance of uremic solutes contributes to ureic fetor.

Clinical significance lies in using fetor as a clue to underlying pathology, though it can be influenced by diet, smoking, and oral hygiene. Evaluation usually focuses on oral health, dental infections, liver function, and renal function. Treatment targets the underlying condition and may include dental care for fetor oris, management of liver or kidney disease, and supportive measures to reduce odor.