Acute cyanide poisoning: are skin findings and odors helpful in making the diagnosis?
2 out of 5 stars Challenges in the diagnosis of acute cyanide poisoning. Parker-Cote JL et al. Clin Toxicol 2018;56(7):609-617 Abstract The stated goal of this somewhat confusing and unfocused article was to “identify isolated acute cyanide poison cases and to identify reported signs, symptoms and laboratory findings.” The authors did a systematic literature review to retrieve cases reports and case series describing patients who were alive on presentation after acute exposure to a cyanide salt. Patients exposed to cyanide in association with smoke inhalation were excluded. They found 65 relevant studies (52 case reports and 13 case series) published between 1967 ad 2015, with a total of 102 individual cases. Common clinical characteristics reported included unresponsiveness (78%,) respiratory failure (73%,) arrhythmias (72%,) and hypotension (54%.) There were 26 deaths. Some anecdotally mentioned distinguishing characteristics of cyanide poisoning were reported only infrequently. A bitter almond odor was documented in 15% of cases, and cherry red skin in 11%. In general, I have little patience with studies such as this that attempt to analyze clinical characteristics of a condition from case reports in the medical literature. The problems of incomplete data reporting from a wide variety of clinicians with different abilities, observation skills, and compulsiveness seem insurmountable. (I have the same problems with papers analyzing cases from poison information ...
Source: The Poison Review - Category: Toxicology Authors: Leon Gussow Tags: Medical bitter almond odor cherry red skin clinical characteristics cyanide poisoning ingestion Source Type: news
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