Sex: F
Vaccine: COVID19
Symptoms: Headache, Hyposmia, Low density lipoprotein, Magnetic resonance imaging, Nerve stimulation test
Clinical narrative: the intermittent phantosmia of smelling smoke became constant and associated with hyposmia; the intermittent phantosmia of smelling smoke became constant and associated with hyposmia; headaches; This is a literature report for the following literature source(s): "Unique Imaging Findings of Neurologic Phantosmia Following Pfizer-BioNtech COVID-19 Vaccination: A Case Report", Topics in Magnetic Resonance Imaging, 2021; Vol:30, pgs:(133-137), DOI:10.1097/RMR.0000000000000287.  A 57 year-old female patient received bnt162b2 (BNT162B2) (Batch/Lot number: unknown) as dose 2, single for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. Vaccination history included: Bnt162b2 (1st dose), for COVID-19 immunisation, reaction(s): "feeling weak", "fatigued", "smelling smoke". The following information was reported: PAROSMIA (medically significant), HYPOSMIA (medically significant), outcome "unknown" and all described as "the intermittent phantosmia of smelling smoke became constant and associated with hyposmia"; HEADACHE (non-serious), outcome "unknown", described as "headaches". The event "the intermittent phantosmia of smelling smoke became constant and associated with hyposmia" and "the intermittent phantosmia of smelling smoke became constant and associated with hyposmia" was evaluated at the emergency room visit. Clinical course: A 57-year-old woman presented to the emergency department complaining of constantly 'smelling smoke' and headaches after her second dose of Pfizer's COVID vaccine. The patient reported a strong reaction to the first vaccine dose, feeling weak, fatigued, with random episodes of 'smelling smoke.' After receiving the second Pfizer COVID, the intermittent phantosmia of 'smelling smoke' became constant and associated with hyposmia to additional odorants and was affecting her quality of life. She denied any parosmia, issues with taste, nasal congestion, rhinorrhea or post-nasal drip, and had no history of sinus infections. Medications included a prescription for Flonase recommended by neurology for the phantosmia occurring after the first vaccination. COVID-19 PCR testing was negative.  The patient underwent the following laboratory tests and procedures: angiogram: dedicated t1-and t2-weighted sequences of the, notes: olfactory tract and bulbs, with and without gadolinium and fat saturation, were obtained; faint left greater than right olfactory tract, notes: enhancement, bone windows demonstrated rightward nasal septal deviation; blood cholesterol: 236 mg/dl, notes: elevated; computerised tomogram head: unremarkable, notes: there was no intracranial hemorrhage, mass, or shift; haematocrit: 41.6, notes: unremarkable; haemoglobin: 13.8, notes: unremarkable; low density lipoprotein: 122 mg/dl, notes: elevated; magnetic resonance imaging: dedicated t1-and t2-weighted sequences of the, notes: olfactory tract and bulbs, with and without gadolinium and fat saturation, were obtained; revealed left greater than, notes: right olfactory bulb and tract enhancement; nerve stimulation test: within normal limits; physical examination: unremarkable cranial nerves ii-xll, with no facial, notes: weakness or asymmetry; sars-cov-2 test: negative; vital signs measurement: unremarkable cranial nerves ii-xll, with no facial, notes: weakness or asymmetry; white blood cell count: 5.49, notes: unremarkable. Therapeutic measures were taken as a result of parosmia, hyposmia.  No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Sender's Comments: based on a positive temporal relationship, causal relationship between the reported events parosmia, hyposmia, headache and the suspect BNT162B2 cannot be excluded.