Salicylate Intoxication with Symptoms of Septicaemia in a 17-Month-Old Girl

Haslinger, V; Dietz, W; Bärtsch, Martina; Simma, B

doi:10.1055/s-0031-1287821

Cited by 1 publication

(1 citation statement)

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“…Salicylate intoxication can be very misleading, especially when there is occult exposure, as in this case. The initial findings of tachypnea, high fever, high lactate levels, and metabolic acidosis mimicked sepsis [ 11 ]. The negative infection parameters in laboratory evaluations made this diagnosis less likely.…”

Section: Discussionmentioning

confidence: 99%

Salicylate Intoxication in an Infant: A Case Report

Santo

Vaz

Jalles

et al. 2017

Drug Saf - Case Rep

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In children, the most common cause of an elevated anion gap (AG) with ketonemia, ketonuria, hyperglycemia, and glycosuria is diabetic ketoacidosis. However, when the clinical history is not clear, other causes must be considered. A 9-month-old girl was transferred to our pediatric intensive care unit (PICU) because of severe metabolic acidosis. On admission, she presented with Kussmaul breathing, tachycardia, irritability, and fever. Blood gasses revealed metabolic acidosis with superimposed respiratory alkalosis and elevated AG. Fluid replacement and bicarbonate for urine alkalinization were started. Ketonemia, acidic urine with glycosuria, ketonuria, and high blood glucose prompted an insulin infusion. Measurement of plasma salicylate confirmed toxic levels. When confronted, the parents admitted to accidentally preparing the child’s bottle with water containing salicylic acid 1000 mg. Although the incidence of salicylate intoxication has declined, it remains an important cause of pediatric morbidity and mortality.

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Section: Discussionmentioning

confidence: 99%