11/66. Accidental clozapine intoxication in a ten-year-old child.clozapine is a tricyclic dibenzodiazepine derivative used commonly in the treatment of schizophrenia. Severe side effects of overdose have been described in children. This report describes the unintentional ingestion of clozapine by a 10-y-o girl, presenting dramatic changes of mental status and progressive alteration of consciousness with a glasgow coma scale drop from 12 to 7. urine analysis revealed 500 microg clozapine/L 24 h after ingestion. Full resolution of symptoms occurred after approximately 55 h with no sequels or alterations at follow-up. awareness must be taken when administering atypical antipsychotics such as clozapine to children because of the severe intoxication effects cases reported.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
12/66. Reversal of an antihistamine-induced coma with flumazenil.flumazenil is a competitive antagonist with specific action at the central benzodiazepine receptor. It is used when benzodiazepine intoxication is suspected. Its use has also been reported in cannabis intoxication, chloral hydrate overdose, hepatic encephalopathy, and alcohol intoxication. We report the case of a 7-month-old male infant with a depressed level of consciousness after intentional intoxication of antihistamines, whose mental status fully recovered after administration of flumazenil. To our knowledge, this is the first case in children where flumazenil has been reported to reverse antihistamine-induced coma.- - - - - - - - - - ranking = 0.8keywords = intoxication (Clic here for more details about this article) |
13/66. hemoperfusion in a child with amitriptyline intoxication.Tricyclic antidepressant overdose is one of the most common causes of serious drug poisoning in children and adults. We report a 17-month-old girl with severe amitriptyline intoxication. She was admitted to hospital because of lethargy and seizures. It was estimated that she took approximately 75 mg/kg of amitriptyline 2 h before admission. On examination she was comatose, had ventricular tachycardia and multifocal clonic seizures. Intravenous fluid, per oral activated charcoal, diazepam, lidocaine, and sodium bicarbonate infusion were given. However, there was no response to this therapy, and the patient remained in a deep coma with cardiac arrhythmias and seizures. hemoperfusion (HP) was performed for 2 h. During this procedure, cardioversion was used six times due to ventricular fibrillation. She had a very good clinical response to HP and no complication was observed. We suggest that HP may be an effective treatment in children with severe amitriptyline intoxication.- - - - - - - - - - ranking = 1.2keywords = intoxication (Clic here for more details about this article) |
14/66. Multiple complications and withdrawal syndrome associated with quetiapine/venlafaxine intoxication.OBJECTIVE: To report a case of quetiapine/venlafaxine intoxication associated with multiple complications and to review their possible relationship with these 2 drugs. CASE SUMMARY: A 53-year-old white man was admitted to the hospital for loss of consciousness secondary to voluntary intoxication with venlafaxine and quetiapine. Several complications were attributable to this intoxication including seizures, prolonged coma, respiratory depression, neuroleptic malignant syndrome, prolonged QRS and QTc intervals, and a possible venlafaxine withdrawal syndrome. DISCUSSION: Quetiapine could be responsible for the neuroleptic malignant syndrome presented in this case. Moreover, venlafaxine intoxication, fever, autonomic instability, and myoclonus presented serotonin syndrome as a differential diagnosis. Potential causes of seizures and prolongation of the QRS and QTc intervals are reviewed. Finally, prolonged coma and late venlafaxine withdrawal are discussed with regard to the pharmacodynamics and pharmacokinetics of drug elimination in the context of intoxication. CONCLUSIONS: Clinicians should be aware of possible complications following intoxication with atypical antipsychotics and anti-depressants, including protracted altered mental status.- - - - - - - - - - ranking = 2keywords = intoxication (Clic here for more details about this article) |
15/66. Severe valproic acid intoxication is associated with atrial tachycardia: secondary detoxication by hemoperfusion.valproic acid is an anticonvulsant drug which is associated with serious toxicity including fatal outcome in case of severe intoxication. Secondary detoxication by hemodialysis or hemoperfusion has been employed successfully in valproic acid intoxication. Cardiac arrhythmias have only been described rarely in valproic acid intoxication in humans. We report on a 15 year-old boy with severe valproic acid intoxication (valproic acid plasma level on admission: 1 150 mg/l) who presented with coma, hypernatremia and atrial tachycardia. The patient was successfully treated with hemoperfusion and intensive supportive care without implementation of a specific antiarrhythmic therapy. We conclude that patients with severe valproic acid intoxication may benefit from secondary detoxication. In addition to generally known symptoms valproic acid intoxication may also be associated with cardiac arrhythmias.- - - - - - - - - - ranking = 2keywords = intoxication (Clic here for more details about this article) |
16/66. Pseudolaminar necrosis in cyanide intoxication: a neuropathology case report.We describe the gross and microscopic neuropathological changes in the brain of a 17-year-old male who died 4 days after being poisoned with cyanide. Previous reports indicate that following cyanide intoxication, the brain develops diffuse hypoxic/ischemic changes, predominantly of the basal ganglia. The case we describe here had similar features but in addition showed striking laminar necrosis of the cerebral cortex. This finding in cyanide poisoning has been previously demonstrated by neuroimaging, but not pathologically.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
17/66. seizures, metabolic acidosis and coma resulting from acute isoniazid intoxication.isoniazid is an anti-tuberculosis drug, used commonly for treatment and prophylaxis of tuberculosis. Acute isoniazid intoxication is characterized by a clinical triad consisting of metabolic acidosis resistant to treatment with sodium bicarbonate, seizures which may be fatal and refractory to standard anticonvulsant therapy, and coma. Treatment requires admission to the intensive care unit for ventilatory support, management of seizures and metabolic acidosis. pyridoxine, in a dose equivalent to the amount of isoniazid ingested, is the only effective antidote. We report the successful treatment of two isoniazid intoxication cases: the case of a child developing an accidental acute isoniazid intoxication and an adult case of isoniazid intoxication with the intent of suicide.- - - - - - - - - - ranking = 1.6keywords = intoxication (Clic here for more details about this article) |
18/66. Near-fatal amitraz intoxication: the overlooked pesticide.Amitraz is commonly used in agricultural industries throughout the world as a farm-animal insecticide. Despite its widespread use, amitraz intoxication is extremely rare and mainly occurs through accidental ingestion by young children. Severe, life-threatening amitraz intoxication in adults is very rarely recognized and reported. Described herein is a previously healthy 54-year-old patient who accidentally ingested a mouthful of liquid amitraz concentrate, and rapidly developed life-threatening clonidine-like overdose syndrome, manifested as nausea, vomiting, hypotension, bradycardia, bradypnoea, and deep coma. Supportive treatment, including mechanical ventilation, and atropine administration resulted in full recovery within 48 hr. Very few cases of near-fatal amitraz poisoning in adults have been described in the medical literature, leading to low awareness of physicians in general practice to the potential toxicity of amitraz. As a consequence, cases of amitraz poisoning are not recognised and therefore erroneously treated as the much more commonly recognized organophosphate and carbamate intoxication. In our discussion, we review the clinical and laboratory manifestations of amitraz poisoning, including clinical hints that aid in the recognition of this often-overlooked diagnosis. Differentiation of amitraz intoxication from the much more commonly seen pesticide-related organophosphate and carbamate intoxication is of utmost importance, in order to avoid erroneous, unnecessary, and often dangerous treatment.- - - - - - - - - - ranking = 1.8keywords = intoxication (Clic here for more details about this article) |
19/66. Pediatric body packing: drug smuggling reaches a new low.The case of a 6-year-old boy presenting with severe clinical manifestations of an opioid intoxication and who is discovered to be an international "body packer" is presented and discussed. This article is the first to report on the phenomenon of body packing in young children. It also highlights the use of prescription opioids as cargo, which has not previously been addressed in the literature.- - - - - - - - - - ranking = 0.2keywords = intoxication (Clic here for more details about this article) |
20/66. child abuse: acute water intoxication in a hyperactive child.A 4-year-8-month-old boy was brought to our emergency department with coma and seizure. Initial physical examination showed evidence of physical child abuse and sudden body weight gain of 3.4 kg in one day. The laboratory results showed normal renal function with severe hyponatremia and the MRI study showed diffuse brain swelling. All of these findings were compatible with the diagnosis of acute water intoxication. Careful history taking from the boy and his parents separately confirmed the course of chronic polydipsia with acute compulsive water drinking. After clinical assessment and follow-up by psychiatrist, the patient was diagnosed with hyperactivity disorder. We present this case and show the possibility of correlation between compulsive water drinking, child abuse and hyperactivity disorder on acute water intoxication.- - - - - - - - - - ranking = 1.2keywords = intoxication (Clic here for more details about this article) |
| <- Previous || Next -> |