Abstract
Cyanide is the fastest and the most fatal poison among other known poisons. It is rapidly absorbed through the respiratory tract and mucous membranes, and can also be absorbed through the gastrointestinal tract and skin. Cyanide can be found as a component in many fruit seeds. If it is chewed and swallowed, it can cause toxic side effects. Confusion and lactic acidosis were determined in a three-year-old child who was admitted to the pediatric emergency room with a complaint of seizure, and according to detailed anamnesis, neurological causes were excluded and cyanide poisoning was diagnosed. An intravenous infusion of hydroxycobalamine (Cyanokit®) was given and rapid response was obtained. We presented this case to call attention to the clinical and laboratory findings of cyanide poisoning, which is rare and can be fatal. Also, we aimed to emphasize the importance of detailed history in intoxications.
Keywords
References
- Palmer M, Betz JM. Plants. In: Goldfrank’s Toxicologic Emergencies, 9th ed, Nelson LS, Lewin NA, Howland MA, Hoffman RS, Goldfrank LR, Flomenbaum NE (Eds), McGraw-Hill, New York 2011. p.1537.
- Osterhoudt KC, Burns-Ewald M, Shannon M, Henretig FM. Toxicologic Emergencies. In: Textbook of Pediatric Emergency Medicine, 6th, Fleisher G, Ludwig S (Eds), Lippincott Williams &Wilkins, Philadelphia 2010. p.1171.
- Hall AH, Linden CH, Kulig KW, Rumack BH. Cyanide poisoning from laetrile ingestion: role of nitrite therapy. Pediatrics 1986; 78:269-72.
- Akyildiz BN, Kurtoğlu S, Kondolot M, Tunç A. Cyanide poisoning caused by ingestion of apricot seeds. Ann Trop Paediatr 2010;30:39-43.
- Suchard JR, Wallace KL, Gerkin RD. Acute cyanide toxicity caused by apricot kernel ingestion. Ann Emerg Med 1998;32:742–4.
- Holzbecher MD, Moss MA, Ellenberger HA. The cyanide content of laetrile preparations, apricot, peach and apple seeds. J Toxicol Clin Toxicol 1984;22:341–7.
- Dalkıran T, Kandur Y, Özaslan M, Acıpayam C, Olgar Ş. Role of Hemodialysis in the Management of Cyanide Intoxication From Apricot Kernels in a 3-Year-Old Child. Pediatr Emerg Care 2020;36: e582-4.
- Mizock BA. Lacticacidosis. Dis Mon 1989; 35:233-300.
- Tursky T, Sajter V. The influence of potassium cyanide poisoning on the gamma-amino butyric acid level in rat brain. J Neurochem 1962; 9:519-23.
- Morocco AP. Cyanides. Crit Care Clin 2005;21:691-705.
- Mohan A, Lee T, Sachdev P. Surviving acute cyanide poisoning: a longitudinal neuropsychological investigation with interval MRI. BMJ Case Rep 2014; 2014: bcr2013203025.
- Doğan M, Yılmaz C, Kaya A, Caksen H, Taksın G. Cyanide intoxication with encephalitis clinic: a case report. Eastern J Med 2006;11:22-5.
- Baud FJ, Borron SW, Mégarbane B, Trout H, Lapostolle F, et al. Value of lactic acidosis in the assessment of the severity of the acute cyanid poisoning. Crit Care Med 2002; 30:2044-50.
- Dooroshi G, Dorostkar A, Rahimi A, Zoofaghari S. An Unusual Acute Cyanide Intoxication. Adv Biomed Res 2020; 9: 42.
- Mintegi S, Clerigue N, Tipo V, Ponticiello E, Lonati D, Burillo-Putze G, et al. Pediatric cyanide poisoning by fire smoke inhalation: a European expert consensus. Toxicology Surveillance System of the Intoxications Working Group of the Spanish Society of Paediatric Emergencies. Pediatr Emerg Care 2013; 29:1234.
Abstract
Siyanür bilinen en hızlı ölümcül zehirler arasında yer alır. Solunum yolu ve mukoz membranlardan hızla emilir, ayrıca gastrointestinal sistem ve deri yoluyla da absorbe edilebilir. Birçok meyve çekirdeğinde bulunan siyanürün toksik yan etkilere neden olabilmesi için çiğnenerek yutulması gerekir. Nöbet yakınmasıyla çocuk acil servise başvuran üç yaşında bir çocukta konfüzyon, laktik asidoz ve ayrıntılı anamnez bilgileri ışığında nörolojik nedenlerden uzaklaşılıp siyanür zehirlenmesi düşünülmüş, hidroksikobalamin (Cyanokit®) intravenöz infüzyonu verilmiş ve hızlı yanıt alınmıştır. Olgu, zehirlenmelerde anamnezin önemine vurgu yaparak nadir görülen ve fatal olabilen siyanür zehirlenmesinin klinik ve laboratuar bulgularına dikkat çekmek amacı ile sunulmuştur.
References
- Palmer M, Betz JM. Plants. In: Goldfrank’s Toxicologic Emergencies, 9th ed, Nelson LS, Lewin NA, Howland MA, Hoffman RS, Goldfrank LR, Flomenbaum NE (Eds), McGraw-Hill, New York 2011. p.1537.
- Osterhoudt KC, Burns-Ewald M, Shannon M, Henretig FM. Toxicologic Emergencies. In: Textbook of Pediatric Emergency Medicine, 6th, Fleisher G, Ludwig S (Eds), Lippincott Williams &Wilkins, Philadelphia 2010. p.1171.
- Hall AH, Linden CH, Kulig KW, Rumack BH. Cyanide poisoning from laetrile ingestion: role of nitrite therapy. Pediatrics 1986; 78:269-72.
- Akyildiz BN, Kurtoğlu S, Kondolot M, Tunç A. Cyanide poisoning caused by ingestion of apricot seeds. Ann Trop Paediatr 2010;30:39-43.
- Suchard JR, Wallace KL, Gerkin RD. Acute cyanide toxicity caused by apricot kernel ingestion. Ann Emerg Med 1998;32:742–4.
- Holzbecher MD, Moss MA, Ellenberger HA. The cyanide content of laetrile preparations, apricot, peach and apple seeds. J Toxicol Clin Toxicol 1984;22:341–7.
- Dalkıran T, Kandur Y, Özaslan M, Acıpayam C, Olgar Ş. Role of Hemodialysis in the Management of Cyanide Intoxication From Apricot Kernels in a 3-Year-Old Child. Pediatr Emerg Care 2020;36: e582-4.
- Mizock BA. Lacticacidosis. Dis Mon 1989; 35:233-300.
- Tursky T, Sajter V. The influence of potassium cyanide poisoning on the gamma-amino butyric acid level in rat brain. J Neurochem 1962; 9:519-23.
- Morocco AP. Cyanides. Crit Care Clin 2005;21:691-705.
- Mohan A, Lee T, Sachdev P. Surviving acute cyanide poisoning: a longitudinal neuropsychological investigation with interval MRI. BMJ Case Rep 2014; 2014: bcr2013203025.
- Doğan M, Yılmaz C, Kaya A, Caksen H, Taksın G. Cyanide intoxication with encephalitis clinic: a case report. Eastern J Med 2006;11:22-5.
- Baud FJ, Borron SW, Mégarbane B, Trout H, Lapostolle F, et al. Value of lactic acidosis in the assessment of the severity of the acute cyanid poisoning. Crit Care Med 2002; 30:2044-50.
- Dooroshi G, Dorostkar A, Rahimi A, Zoofaghari S. An Unusual Acute Cyanide Intoxication. Adv Biomed Res 2020; 9: 42.
- Mintegi S, Clerigue N, Tipo V, Ponticiello E, Lonati D, Burillo-Putze G, et al. Pediatric cyanide poisoning by fire smoke inhalation: a European expert consensus. Toxicology Surveillance System of the Intoxications Working Group of the Spanish Society of Paediatric Emergencies. Pediatr Emerg Care 2013; 29:1234.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | CASE REPORTS |
| Authors | |
| Publication Date | November 26, 2021 |
| Submission Date | January 6, 2021 |
| Published in Issue | Year 2021 Volume: 15 Issue: 6 |
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