Acute severe poisoning with disinfectant in senior aged patient-case report and overview of literature considering age influence on treatment decision in alcohol-based intoxications.

Autor:	Pereska Z; Faculty of Medicine, Ss Cyril and Methodius University, University Clinic of Toxicology, Skopje, North Macedonia., Simonovska N; Faculty of Medicine, Ss Cyril and Methodius University, University Clinic of Toxicology, Skopje, North Macedonia., Babulovska A; Faculty of Medicine, Ss Cyril and Methodius University, University Clinic of Toxicology, Skopje, North Macedonia., Berat-Huseini A; Faculty of Medicine, Ss Cyril and Methodius University, University Clinic of Toxicology, Skopje, North Macedonia., Naumoski K; Faculty of Medicine, Ss Cyril and Methodius University, University Clinic of Toxicology, Skopje, North Macedonia., Kostadinoski K; Faculty of Medicine, Ss Cyril and Methodius University, University Clinic of Toxicology, Skopje, North Macedonia.
Jazyk:	angličtina
Zdroj:	SAGE open medical case reports [SAGE Open Med Case Rep] 2021 Sep 19; Vol. 9, pp. 2050313X211047717. Date of Electronic Publication: 2021 Sep 19 (Print Publication: 2021).
DOI:	10.1177/2050313X211047717
Abstrakt:	We present our experiences in the first case of severe suicidal poisoning with 70% ethanol-disinfectant in North Macedonia, in an elderly patient with immunocompromising comorbidities. A 66-year-old unconscious woman was admitted at our clinic, with a history of seropositive rheumatoid arthritis treated with methotrexate. She was in a coma, without signs of serotonin syndrome, recurrent episodes of cardio-respiratory insufficiency under supportive treatment without invasive ventilation, metabolic acidosis, increased D-dimer 3254 ng/mL. The toxicology screening confirmed low benzodiazepines levels and alcoholaemia of 526 mg/dL (5.26 g/L), due to ingestion of 70% ethanol. Considering the decreased biotransformation in the elderly, immunocompromising comorbidities, reports of fatal outcome in poisoned elderly patients with disinfectants under standard fluids supportive protocol, haemodialysis was initiated, with registered associated hypercoagulability which resulted in complete stabilization after 48 h of admission. Treatment protocols of poisoning with ethanol-based disinfectant in the elderly should consider timely performing haemodialysis at lower alcoholaemia levels than recommended. Competing Interests: Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article. (© The Author(s) 2021.)
Databáze:	MEDLINE
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