What have we here? A man or a fish?

摘要

In January, 2006, a 45-year-old man presented to our department; he complained of a strong objectionable body odour, resembling the aroma offish, which had a profound influence on his life. He decided to seek help, because of marital problems related to his body odour. His wife noticed that the smell was present in his sweat, urine, semen, and saliva, and it got worse with consumption of certain food products. He had been offered a better job, but declined when he noticed that he had to sit in the same room with new colleagues. He used excessive amounts of perfume to mask the body odour and always tried to sit near open windows. He had low self-esteem and suffered multiple episodes of depression and anxiety attacks. Although his brother and father had the same symptoms they never discussed this with family members. The diagnosis was unclear and a Google search led us to a probable diagnosis of trimethylaminuria.