1/24. mercury intoxication presenting with hypertension and tachycardia.An 11 year old girl presented with hypertension and tachycardia. Excess urinary catecholamine excretion suggested phaeochromocytoma but imaging studies failed to demonstrate a tumour. Other symptoms included insomnia and weight loss, and she was found to have a raised concentration of mercury in blood and urine. mercury intoxication should be considered in the differential diagnosis of hypertension with tachycardia even in patients presenting without the skin lesions typical of mercury intoxication and without a history of exposure.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
2/24. theophylline intoxication mimicking diabetic ketoacidosis in a child.A 5-year-old boy presented with abdominal pain, nausea and vomiting of blood. Twelve hours after admission, "diabetic ketoacidosis" was diagnosed on the basis of elevated glycaemia, glycosuria, ketonuria and a low bicarbonate blood level, which led to treatment with fluids and regular insulin infusion. Over a 36-hour period, insulin was progressively decreased and finally stopped because of the rapid fall and normalization of blood glucose concentration. Drug poisoning was suspected on the basis of persistent tachycardia in the absence of other signs of dehydration. Salicylate intoxication was excluded, and theophylline was finally incriminated. This compound, used by adults in the child's home, had caused accidental theophylline poisoning, mimicking diabetic ketoacidosis. Pre-diabetic immune markers were repeatedly negative, and no diabetes has developed after four years of follow-up. Thus, the transient increase in blood glucose was not related to a pre-diabetic status. A diagnosis of masked theophylline poisoning should be considered in similar situations involving a rapid decrease of insulin requirements.- - - - - - - - - - ranking = 0.83333333333333keywords = intoxication (Clic here for more details about this article) |
3/24. His bundle electrogram during bidirectional tachycardia.The case is reported of a 66-year-old woman with bidirectional tachycardia caused by digitalis intoxication. His bundle records demonstrated the presence of two foci, one junctional and the other a fascicular one.- - - - - - - - - - ranking = 0.16666666666667keywords = intoxication (Clic here for more details about this article) |
4/24. death by quinine.We report a case of a man with a 9.75 g ingestion of quinine. The patient presented with recurrent pulseless wide complex tachycardia for which he received sodium bicarbonate, defibrillation and overdrive mechanical pacing. Despite treatment, the patient died. quinine is still available for the treatment of leg cramps and drug-resistant malaria. In overdose, quinine affects multiple organ systems, including vision, hearing, the cardiovascular, and renal systems. We review the current approach to quinine intoxication.- - - - - - - - - - ranking = 0.16666666666667keywords = intoxication (Clic here for more details about this article) |
5/24. Wide QRS tachycardia caused by severe hyperkalaemia and digoxin intoxication.We report the case of a 78-year-old woman, with previous narrow QRS atrial fibrillation, who in the presence of mild digoxin intoxication and severe hyperkalaemia, caused by chronic renal failure and usage of potassium sparing drugs, presented on her ECG two distinct wide QRS tachycardias. Initial treatment with low doses of procainamide resulted in severe bradycardia. Her original rhythm was restored after partial correction of hyperkalaemia with haemodialysis under continuous infusion of lidocaine. The electrocardiographic manifestations of hyperkalaemia and digoxin intoxication as well as the effect of lidocaine and procainamide on hyperkalaemia-induced wide QRS tachycardias are discussed.- - - - - - - - - - ranking = 1keywords = intoxication (Clic here for more details about this article) |
6/24. Acute nutmeg intoxication.Nutmeg is a common household spice sometimes abused for its hallucinogenic properties. This abuse is well reported in the medical literature over the last century. Ingestion of less than one tablespoon can produce symptoms similar to those of an anticholinergic toxic episode. Common presenting complaints are hallucinations, palpitations, and feelings of impending doom. We report a case of intentional nutmeg intoxication in a 23-year-old college student. As laboratory tests are usually normal, this diagnosis should be considered in patients presenting with an acute psychotic break accompanied by symptoms resembling an anticholinergic toxic episode. Treatment is primarily supportive once other life-threatening conditions have been ruled out.- - - - - - - - - - ranking = 0.83333333333333keywords = intoxication (Clic here for more details about this article) |
7/24. Electrocardiographic findings after acute absinthe intoxication.A 29-year-old comatose patient was brought to Emergency Department with severe alcohol intoxication. No risk factors or cardiac abnormalities were documented. The analysis was negative for other drugs. plasma electrolyte and cardiac enzymes were normal. The electrocardiogram showed Mobitz type-I atrioventricular block that developed to a rapid junctional rhythm. The patient was stabilized and recovered completely, electrocardiogram then showed sinus rhythm. He admitted important absinthe consumption. Although tachyarrhythmias are frequently developed in acute alcohol intoxication, bradyarrhythmias are exceptional in this context. We present a Wenckebach-type atrioventricular-block in severe alcohol intoxication with absinthe that developed to a rapid junctional rhythm, never described before.- - - - - - - - - - ranking = 1.1666666666667keywords = intoxication (Clic here for more details about this article) |
8/24. Torsade de pointes and T-U wave alternans associated with arsenic poisoning.Arsenic intoxication is a common form of heavy metal poisoning. Although arsenic-induced circulatory collapse, seizures, and syncope are well known, the potential for serious ventricular arrhythmias is less well recognized. Reported in this study are two cases of arsenic poisoning causing torsade de pointes. Furthermore, marked prolongation of the QT-U interval and the rarely observed phenomenon of T-U wave alternans are demonstrated. Thus, arsenic intoxication may be complicated by prolongation of the QT-U interval and torsade de pointes. T-U wave alternans occurs in the presence of a long QT-U interval and may be an electrocardiographic warning sign of torsade de pointes.- - - - - - - - - - ranking = 0.33333333333333keywords = intoxication (Clic here for more details about this article) |
9/24. Reversal of orphenadrine-induced ventricular tachycardia with physostigmine.A 3-year-old boy developed confusion, generalized tonic-clonic seizures, and sustained ventricular tachycardia following ingestion of an unknown quantity of orphenadrine (Norflex). Although refractory to precordial thump, synchronous cardioversion, and lidocaine, the ventricular tachycardia was reversed by intravenous administration of the tertiary acetylcholinesterase inhibitor physostigmine. We discuss the underlying physiology and manifestations of anticholinergic overdose, the specific manifestations of orphenadrine overdose, and the current recommendations regarding the utilization and toxicity of physostigmine in the treatment of anticholinergic syndromes and orphenadrine intoxication.- - - - - - - - - - ranking = 0.16666666666667keywords = intoxication (Clic here for more details about this article) |
10/24. Treatment of severe imipramine poisoning complicated by a negative history of drug ingestion.The wide use of imipramine (Tofranil) for the treatment of nocturnal enuresis continues in spite of the unique dangers associated with this drug. Young children are particularly susceptible to the potentially lethal central nervous system and cardiovascular toxicities, yet the toxic potential of imipramine remains unrecognized by both parents and too many physicians. Management of severe imipramine intoxication can be difficult. This report describes a 12-month-old patient with severe imipramine intoxication whose treatment was complicated by a negative history at presentation.- - - - - - - - - - ranking = 0.33333333333333keywords = intoxication (Clic here for more details about this article) |
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