Cocaine intoxication: massive oral overdose

Massive cocaine intoxication is manifested by central nervous system stimulation (restlessness, tremors, convulsions) and then depression (respiratory and cardiovascular failure). A young man presented with new seizures and eventual development of status epilepticus, respiratory failure, and cardiovascular depression. Investigation revealed ingestion of cocaine-filled condoms which had ruptured in the gastrointestinal tract. Smuggling of illicit drugs via the oral-fecal route may lead to severe physiologic derangements if the container ruptures.