Cyanide intoxication with encephalitis clinic: a case report

Yıl 2006, Cilt: 11 Sayı: 1-2, 22 - 25, 20.03.2013

Murat Dogan Cahide Yilmaz Avni Kaya Huseyin Caksen Gokmen Taskin

Öz

Abstract.Cyanide intoxication is one of the most dangerous poisonings and may occur by oral, respiratuary and dermal routes. Central nervous system is the most susceptible region to acute cyanide intoxication. A 3.5-years-old-girl was brought to our pediatric emergency polyclinic with complaints of fever, dullness and convulsion. On physical examination, lethargy and agitation, increased deep tendon reflexes and bilateral extensor plantar response were determined. On brain magnetic resonance imaging, increased signal intensity and decreased diffusion in bilateral basal ganglia on T2-fluid-attenuated inversion-recovery sequences were determined. The patient diagnosed as intoxication or encephalitis was taken to intensive care unit. Gastric lavage was performed and activated charcoal and acyclovir were given. After these managements, it was learnt that she had eaten a lot of apricot, plum and seed of apricot before the complaints. Therefore, she was diagnosed as cyanide intoxication and hydroxycobalamin treatment was given for five days. Our aim is to emphasize that in patients who were brought with symptoms and signs of encephalitis, intoxications also should be thought in differential diagnosis; therefore, we want to underline once again that taking detailed anamnesis is very important.

Key words: Cyanide intoxication; encephalitis; children

Anahtar Kelimeler

Cyanide intoxication, encephalitis, children

Kaynakça

• 1. Poyrazoglu MH, Kurtoglu S, Aydin K, Yuksel S, Ustunbas HB. Kayısı çekirdeğine bağlı siyanid zehirlenmesi (18 olgunun incelenmesi ve yorum). Türk Pediatri Arşivi 1997;32: 24-27 (in Turkish).
• 2. Agency for Toxic Substances and Disease Registry. Toxicological profile for cyanide (update). Atlanta: US Department of Health and Human Services, Public Health Service, 2006 June, 1-341. ATSDR/TP-92/09.
• 3. Lasch EE, El Shawa R. Multiple cases of cyanide poisoning by apricot kernels in children from Gaza. Pediatrics 1981;68: 5-7.
• 4. Rachinger J, Fellner FA, Stieglbauer K. MR changes after acute cyanide intoxication. AJNR Am J Neuroradiol 2002;23: 1398-1401.