Complete Recovery Following Intentional Potassium Cyanide Poisoning Despite Delayed Hydroxocobalamin Administration:...

Cyanide poisoning is rare but is characterized by rapid clinical deterioration and a high risk of mortality. We present the case of a 25-year-old woman with suspected ingestion of up to 5 g of potassium cyanide purchased online in a suicide attempt. On admission, the patient was in critical condition, presenting with severe impairment of consciousness, respiratory failure, and circulatory shock. Hydroxocobalamin was administered approximately four hours after admission due to the need to obtain the antidote from another institution. Until specific treatment became available, intensive supportive therapy and stabilization of vital functions were provided. Despite ingestion of a potentially lethal dose of cyanide and limited immediate availability of the antidote, complete clinical stabilization was achieved, and the patient was discharged in good general condition on hospital day 15 without permanent organ damage or neurological deficits. This case highlights the importance of early initiation of intensive supportive care to maintain vital functions and serve as a bridge until specific antidotal treatment can be administered.