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Shock, metabolic acidosis, and coma following ibuprofen overdose in a child
1Department of Pediatrics, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick 08903, USA.
Insights
A child experienced severe complications, including shock and coma, after an ibuprofen overdose. Early medical intervention led to a full recovery, highlighting the importance of prompt treatment for significant ibuprofen ingestions.
Area of Science:
- Pediatric Toxicology
- Clinical Case Reports
- Adverse Drug Events
Background:
- Ibuprofen is a common over-the-counter nonsteroidal anti-inflammatory drug (NSAID).
- While generally safe, overdose can lead to serious toxicity in children.
- Understanding the spectrum of ibuprofen toxicity is crucial for pediatric emergency care.
Observation:
- A 6-year-old boy presented with shock, coma, and metabolic acidosis after ingesting approximately 6,000 mg of ibuprofen.
- The patient had no significant prior medical history.
- Initial presentation indicated severe systemic effects from the overdose.
Findings:
- The child's critical condition included profound metabolic acidosis, shock, and loss of consciousness.
- Successful management involved tracheal intubation, mechanical ventilation, aggressive fluid resuscitation, and administration of activated charcoal.
- The patient recovered completely without any lasting sequelae.
Implications:
- This case underscores that ibuprofen overdose, though rare, can cause severe and life-threatening complications in children.
- Prompt and aggressive medical interventions are critical for favorable outcomes in pediatric ibuprofen toxicity.
- Healthcare providers should maintain a high index of suspicion for serious complications even with common medications like ibuprofen.
Objective:
To report a child who developed shock, loss of consciousness, and metabolic acidosis following an ibuprofen overdose.
Case Summary:
A 6-year-old boy with no prior medical problems ingested approximately thirty 200-mg tablets of ibuprofen. The patient developed shock, coma, and metabolic acidosis. He was treated successfully with intubation and mechanical ventilation, fluid resuscitation, and decontamination with activated charcoal. The patient was discharged without any clinical sequelae.
Discussion:
Serious adverse complications following ibuprofen overdose have been reported rarely in children. We reviewed literature pertaining to the etiology, pharmacology, pathophysiology, and management of complications following ibuprofen overdoses, as well as other case reports.
Conclusions:
Coma, metabolic acidosis, and shock were noted in a child who ingested a large quantity of ibuprofen. These complications have been described rarely in children. We attribute his favorable clinical outcome to early and aggressive intervention consisting of tracheal intubation, fluid resuscitation, and decontamination with activated charcoal. Although ibuprofen overdoses are usually benign, healthcare professionals should be aware of the various potentially serious complications that may occur.