Related Experiment Video
Updated: Feb 18, 2026
06:12
Inducing Acute Liver Injury in Rats via Carbon Tetrachloride CCl4 Exposure Through an Orogastric Tube
Published on: April 28, 2020
12.1K
Salicylate Intoxication in an Infant: A Case Report
Rita Espírito Santo1, Sara Vaz2,3, Filipa Jalles1
1Intensive Care Unit, Paediatric Department, Hospital of Santa Maria, Lisbon, Portugal.
Drug Safety - Case Reports
|November 29, 2017
Summary
Salicylate poisoning can mimic diabetic ketoacidosis in children, presenting with high anion gap metabolic acidosis. Early identification and treatment are crucial for managing this potentially fatal condition.
Area of Science:
- Pediatrics
- Toxicology
- Emergency Medicine
Background:
- Diabetic ketoacidosis is the most common cause of elevated anion gap metabolic acidosis with ketonemia in children.
- Non-diabetic causes of these metabolic derangements require consideration, especially when clinical history is unclear.
Purpose of the Study:
- To highlight salicylate intoxication as a critical differential diagnosis in pediatric patients presenting with metabolic acidosis and ketosis.
- To emphasize the importance of a thorough toxicological history in pediatric emergencies.
Main Methods:
- Case report of a 9-month-old infant presenting with severe metabolic acidosis.
- Clinical examination, blood gas analysis, urine and blood tests for ketones, glucose, and salicylate levels.
- Review of clinical presentation and management of salicylate poisoning.
Main Results:
- The infant presented with Kussmaul breathing, tachycardia, fever, and elevated anion gap metabolic acidosis.
- Laboratory findings included ketonemia, ketonuria, glycosuria, and hyperglycemia, initially suggestive of diabetic ketoacidosis.
- Plasma salicylate levels confirmed toxic levels, revealing accidental salicylate poisoning as the cause.
Conclusions:
- Salicylate intoxication can present with signs and symptoms mimicking diabetic ketoacidosis in children.
- Accurate and rapid diagnosis, including toxicological screening, is vital for appropriate management and improved outcomes.
- Despite declining incidence, salicylate poisoning remains a significant cause of pediatric morbidity and mortality.
Related Concept Videos
01:26Pharmaceutical Poisoning: Potential Scenarios
17
Pharmaceutical poisoning can occur through various channels, impacting an estimated 2 million hospitalized patients in the U.S. annually with serious adverse drug responses. These scenarios encompass both therapeutic uses, such as drug toxicity, where even standard dosages can lead to severe central nervous system depression, and non-therapeutic exposures, including accidental ingestion by children, and environmental and occupational exposures.Unintentional poisonings often involve exploratory...
17
01:23Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
324
Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
324
01:14Prevention of Further Absorption of Poison
1.3K
In cases of acute poisoning, the primary objective is to prevent further absorption of the toxic substance into the body. Immediate interventions using various decontamination techniques targeting the gastrointestinal (GI) tract can achieve this. Decontamination is crucial to prevent poison from entering the systemic circulation, which involves washing affected areas with water and mild soap and removing contaminated clothing. Once external decontamination is done, attention must be turned to...
1.3K
01:26Pharmaceutical Poisoning: Treatment Strategies
33
Treatment strategies for poisoning are a critical aspect of emergency medicine, focusing on preventing the absorption of toxins and enhancing their elimination. When a poisoning incident occurs, the first response is to halt exposure and decontaminate the patient, particularly through gastrointestinal (GI) methods if the poison was ingested.Gastrointestinal Decontamination Techniques:Activated charcoal is the cornerstone of GI decontamination. It works through adsorption, binding the toxin to...
33
01:26Anticholinesterase Agents: Poisoning and Treatment
1.7K
Anticholinesterases, also known as cholinesterase inhibitors, work by blocking the breakdown of acetylcholine, leading to its accumulation in the synaptic cleft. This accumulation indirectly enhances both muscarinic and nicotinic actions. These agents are classified as reversible or irreversible based on their mechanism of action.
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
Irreversible agents form a strong bond with the cholinesterase enzyme, making it inactive. The breakdown of the phosphorylated enzyme is...
1.7K
01:24Pharmacokinetics in Pediatric Patients: Drug Metabolism
257
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
257