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Carbon Monoxide Poisoning: The Great Imitator
Christopher Velasquez1, Tye Patchana2, Brian McParland1
1Michigan State University College of Osteopathic Medicine, East Lansing, MI. Beaumont Hospital Southshore Campus, Trenton, MI.
Spartan Medical Research Journal
|March 3, 2021
Summary
Carbon monoxide poisoning can cause varied symptoms. Bilateral globus pallidus lesions on brain imaging may aid in diagnosing and predicting outcomes of carbon monoxide poisoning, especially with delayed presentation.
Area of Science:
- Neurology
- Toxicology
- Cardiology
Background:
- Carbon monoxide (CO) poisoning is a significant cause of fatal poisonings in the US.
- Clinical presentation of CO poisoning is variable due to the gas's targeting of highly metabolic tissues.
Observation:
- A man in his 30s presented with altered mental status, fatigue, headache, and flu-like symptoms after using a portable diesel heater in his garage.
- Neurology and cardiology workup revealed bilateral globus pallidus lesions, elevated troponin, elevated liver enzymes, and acute kidney failure.
- Carboxyhemoglobin (COHb) levels may be less reliable in delayed presentations, particularly in smokers.
Findings:
- The case highlights bilateral globus pallidus (GP) lesions as a key indicator in diagnosing CO poisoning.
- Damage to highly metabolic tissues, evidenced by GP lesions, can inform prognosis.
- The study emphasizes the diagnostic and prognostic value of neuroimaging findings in CO poisoning.
Implications:
- Recognizing bilateral GP lesions can lead to earlier diagnosis and treatment of CO poisoning.
- Understanding the link between GP necrosis and patient outcomes can improve patient management.
- This case contributes to further research on CO poisoning, aiming to reduce morbidity and mortality.
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