Cardiovascular collapse following povidone-iodine wash
H Ramaswamykanive1, Z Nanavati, J Mackie
1Intensive Care Unit, Prince of Wales Hospital, Sydney, New South Wales, Australia. rkhariharan@hotmail.com
Insights
Severe iodine toxicity from povidone-iodine wash can cause serious health issues like cardiovascular collapse and seizures. Early diagnosis and supportive care are crucial for managing this rare but dangerous condition.
Area of Science:
- Clinical Medicine
- Toxicology
Background:
- Povidone-iodine has been a widely used antiseptic since 1952.
- Iodine toxicity from povidone-iodine is a rare but serious adverse effect.
- Diagnosis requires a high index of suspicion due to its rarity and non-specific symptoms.
Abstract:
We present a case study of a severe episode of iodine toxicity following povidone-iodine wash with clinical manifestations of cardiovascular collapse, metabolic acidosis, renal failure and seizures. Povidone-iodine has been used as a medical antiseptic and disinfectant since 1952 Iodine toxicity secondary to povidone-iodine use is rare. Iodine toxicity is difficult to diagnose and the diagnosis is made by a high index of suspicion. Toxicity due to iodine correlates with serum and urine iodine levels. Treatment of iodine toxicity is supportive. A review of literature relating to the components of povidone-iodine, iodine metabolism, its manifestations and management of iodine toxicity secondary to povidone-iodine is also presented. An Ovid-Medline search from 1950 to 2009 revealed 1236 articles on the clinical manifestations of povidone-iodine usage but no article on iodine toxicity relating to povidone-iodine based on the following search criteria: povidone-iodine and/or iodine toxicity secondary to povidone-iodine (limited to English language, review articles, full text and human patients).
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