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Uncontrolled Agitation and Flushed Face Due to Tropicamide: A Missed Diagnosis

Year 2017, Volume: 8 Issue: 3, 59 - 61, 01.07.2017

Abstract

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References

  • Labetoulle M, Frau É, Le Jeunne C. Systemic adverse effects of topical ocular treatments. Presse Med 2005; 34: 589-95. [CrossRef ]
  • Alpay A, Ermis B, Ugurbas SC, Battal F, Sagdik HM. The local vasocon- striction of infant's skin following instillation of mydriatic eye drops. Eur J Clin Pharmacol 2010; 66: 1161-4. [CrossRef ]
  • Coco TJ, Liebelt EL. General Approach to Poisoning. In Baren JM, Ro- throck SG, Brennan JA, Brown L, eds. Pediatric Emergency Medicine. Philadelphia: Saunders, Elsevier PA; 2008. p.106-14. [CrossRef ]
  • Reilly KM, Chan L, Mehta NJ, Salluzzo RF. Systemic toxicity from ocular homatropine. Acad Emerg Med 1996; 3: 868-71. [CrossRef ]
  • Micromedex® 2.0. Truven Health Analytics, Greenwood Village, Colo- rado, USA. Available from: http://www.micromedexsolutions.com/
  • Brunner GA, Fleck S, Pieber TR, Lueger A, Kaufmann P, Smolle KH, et al. Near fatal anticholinergic intoxication after routine fundoscopy. Inten- sive Care Med 1998; 24: 730-1. [CrossRef ]
  • Burns MJ, Linden CH, Graudins A, Brown RM, Fletcher KE. A comparison of physostigmine and benzodiazepines for the treatment of anticholin- ergic poisoning. Ann Emerg Med 2000; 35: 374-81. [CrossRef ]
  • Lee AC, So KT. Acute anticholinergic poisoning in children. Hong Kong Med J 2005; 11: 520-3.
  • J Emerg Med Case Rep 2017; 8: 59-61
  • Özkaya et al. Tropicamide and Anticholinergic Syndrome

Uncontrolled Agitation and Flushed Face Due to Tropicamide: A Missed Diagnosis

Year 2017, Volume: 8 Issue: 3, 59 - 61, 01.07.2017

Abstract

Introduction: Topical ophthalmic drugs that are not used in appropriate doses may lead to overdose symptoms.Case Report: A 2-month-old boy presented to the emergency department with extreme agitation, flushed face, mydriasis, cataract in the left eye, dry oral mucosa, spasticity in all extremities, and wheezing. It was learned that the patient had been receiving eye drops containing tropicamide at repeated doses before ophthalmologic evaluation. Pheniramine maleate and methylprednisolone were given to counter the drug-related side-effects or allergic reactions to the eye drop. At the follow-up, his symptoms and findings had become exacerbated, and he was admitted to the pediatric intensive care unit due to shock and drug-related anticholinergic toxicity.Conclusion: This case illustrates the importance of recognizing toxidromes at differential diagnosis and is the first reported pediatric case with tropicamide-induced anticholinergic syndrome

References

  • Labetoulle M, Frau É, Le Jeunne C. Systemic adverse effects of topical ocular treatments. Presse Med 2005; 34: 589-95. [CrossRef ]
  • Alpay A, Ermis B, Ugurbas SC, Battal F, Sagdik HM. The local vasocon- striction of infant's skin following instillation of mydriatic eye drops. Eur J Clin Pharmacol 2010; 66: 1161-4. [CrossRef ]
  • Coco TJ, Liebelt EL. General Approach to Poisoning. In Baren JM, Ro- throck SG, Brennan JA, Brown L, eds. Pediatric Emergency Medicine. Philadelphia: Saunders, Elsevier PA; 2008. p.106-14. [CrossRef ]
  • Reilly KM, Chan L, Mehta NJ, Salluzzo RF. Systemic toxicity from ocular homatropine. Acad Emerg Med 1996; 3: 868-71. [CrossRef ]
  • Micromedex® 2.0. Truven Health Analytics, Greenwood Village, Colo- rado, USA. Available from: http://www.micromedexsolutions.com/
  • Brunner GA, Fleck S, Pieber TR, Lueger A, Kaufmann P, Smolle KH, et al. Near fatal anticholinergic intoxication after routine fundoscopy. Inten- sive Care Med 1998; 24: 730-1. [CrossRef ]
  • Burns MJ, Linden CH, Graudins A, Brown RM, Fletcher KE. A comparison of physostigmine and benzodiazepines for the treatment of anticholin- ergic poisoning. Ann Emerg Med 2000; 35: 374-81. [CrossRef ]
  • Lee AC, So KT. Acute anticholinergic poisoning in children. Hong Kong Med J 2005; 11: 520-3.
  • J Emerg Med Case Rep 2017; 8: 59-61
  • Özkaya et al. Tropicamide and Anticholinergic Syndrome
There are 10 citations in total.

Details

Other ID JA22UU82MB
Journal Section Case Report
Authors

Ahmet Kağan Özkaya

Sinem Sarı Gökay This is me

Özlem Tolu Kendir This is me

Rıza Dinçer Yıldızdaş This is me

Hayri Levent Yılmaz This is me

Publication Date July 1, 2017
Submission Date July 1, 2017
Published in Issue Year 2017 Volume: 8 Issue: 3

Cite

APA Özkaya, A. K., Gökay, S. S., Kendir, Ö. T., Yıldızdaş, R. D., et al. (2017). Uncontrolled Agitation and Flushed Face Due to Tropicamide: A Missed Diagnosis. Journal of Emergency Medicine Case Reports, 8(3), 59-61.
AMA Özkaya AK, Gökay SS, Kendir ÖT, Yıldızdaş RD, Yılmaz HL. Uncontrolled Agitation and Flushed Face Due to Tropicamide: A Missed Diagnosis. Journal of Emergency Medicine Case Reports. July 2017;8(3):59-61.
Chicago Özkaya, Ahmet Kağan, Sinem Sarı Gökay, Özlem Tolu Kendir, Rıza Dinçer Yıldızdaş, and Hayri Levent Yılmaz. “Uncontrolled Agitation and Flushed Face Due to Tropicamide: A Missed Diagnosis”. Journal of Emergency Medicine Case Reports 8, no. 3 (July 2017): 59-61.
EndNote Özkaya AK, Gökay SS, Kendir ÖT, Yıldızdaş RD, Yılmaz HL (July 1, 2017) Uncontrolled Agitation and Flushed Face Due to Tropicamide: A Missed Diagnosis. Journal of Emergency Medicine Case Reports 8 3 59–61.
IEEE A. K. Özkaya, S. S. Gökay, Ö. T. Kendir, R. D. Yıldızdaş, and H. L. Yılmaz, “Uncontrolled Agitation and Flushed Face Due to Tropicamide: A Missed Diagnosis”, Journal of Emergency Medicine Case Reports, vol. 8, no. 3, pp. 59–61, 2017.
ISNAD Özkaya, Ahmet Kağan et al. “Uncontrolled Agitation and Flushed Face Due to Tropicamide: A Missed Diagnosis”. Journal of Emergency Medicine Case Reports 8/3 (July 2017), 59-61.
JAMA Özkaya AK, Gökay SS, Kendir ÖT, Yıldızdaş RD, Yılmaz HL. Uncontrolled Agitation and Flushed Face Due to Tropicamide: A Missed Diagnosis. Journal of Emergency Medicine Case Reports. 2017;8:59–61.
MLA Özkaya, Ahmet Kağan et al. “Uncontrolled Agitation and Flushed Face Due to Tropicamide: A Missed Diagnosis”. Journal of Emergency Medicine Case Reports, vol. 8, no. 3, 2017, pp. 59-61.
Vancouver Özkaya AK, Gökay SS, Kendir ÖT, Yıldızdaş RD, Yılmaz HL. Uncontrolled Agitation and Flushed Face Due to Tropicamide: A Missed Diagnosis. Journal of Emergency Medicine Case Reports. 2017;8(3):59-61.