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A case report of bittern intoxication.
Hyun Min Jung1, Jin Hui Paik1, Ji Hye Kim1
1Department of Emergency Medicine, College of Medicine, Inha University, Incheon, South Korea.
Journal of Emergencies, Trauma, and Shock
|May 8, 2015
Summary
Bittern poisoning can cause severe electrolyte imbalances, including hypermagnesemia and hypernatremia. Prompt fluid therapy and electrolyte correction are crucial for patient recovery and preventing serious complications.
Area of Science:
- Toxicology
- Emergency Medicine
- Clinical Chemistry
Background:
- Bittern, a marine byproduct rich in magnesium and sodium salts, is traditionally used in tofu production and historically in chemical weapons.
- Ingestion of bittern can lead to significant electrolyte disturbances due to its high concentration of magnesium chloride, magnesium sulfate, potassium chloride, sodium chloride, and magnesium bromide.
Observation:
- A 73-year-old female presented with altered mental status after ingesting bittern.
- Initial assessment revealed hypermagnesemia (7.8 mEq/L) and hypernatremia (149 mEq/L), with electrocardiograph showing QT prolongation (0.482 s).
- Cranial CT and MRI scans showed no acute abnormalities, indicating the primary issue was metabolic.
Findings:
- The patient's symptoms of dizziness, weakness, and altered mental state were attributed to severe electrolyte imbalances.
- Successful management involved fluid therapy and intravenous calcium gluconate, leading to the correction of hypermagnesemia and hypernatremia.
- The patient was discharged without complications, highlighting the reversibility of acute bittern toxicity with appropriate medical intervention.
Implications:
- This case underscores the potential for severe toxicity from bittern ingestion, emphasizing the need for awareness among healthcare professionals.
- Close monitoring of electrolytes and electrocardiographic changes is mandatory for patients with suspected bittern poisoning.
- Early recognition and management of electrolyte disturbances are critical to prevent life-threatening complications such as cardiac arrhythmias and respiratory depression.
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