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Cyanide poisoning, 2 cases report and treatment review

S Ruangkanchanasetr1, V Wananukul, S Suwanjutha

  • 1Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|March 24, 2000
PubMed

Insights

Two children experienced severe cyanide poisoning after consuming boiled cassava. Prompt treatment with sodium nitrite and sodium thiosulfate led to recovery, highlighting the effectiveness of cyanide antidote therapy.

Area of Science:

  • Toxicology
  • Emergency Medicine
  • Pediatrics

Background:

  • Cyanide poisoning is a life-threatening condition that can result from ingestion of certain foods, such as cassava.
  • Early recognition and intervention are crucial for patient survival and favorable outcomes.

Observation:

  • Two pediatric patients presented with symptoms of cyanide poisoning, including vomiting and coma, 9 hours after ingesting boiled cassava.
  • Elevated blood cyanide levels confirmed the diagnosis, alongside metabolic acidosis and lactic acidemia.

Findings:

  • The 4-year-old girl received prompt administration of sodium nitrite and sodium thiosulfate, leading to recovery with normal breathing the following day.
  • The 1.5-year-old boy, who received only supportive treatment, showed improvement but presented with a characteristic bitter almond breath.

Implications:

  • This case report underscores the critical role of timely administration of cyanide antidotes in managing poisoning cases.
  • Highlighting the potential toxicity of cassava and the importance of recognizing cyanide poisoning symptoms in pediatric patients.
  • Emphasizes the need for accessible and rapid diagnostic and treatment protocols for cyanide poisoning in community hospitals.

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