CASE REPORT
A patient with toxic encephalopathy associated with acute carbon monoxide poisoning–A clinical case
 
More details
Hide details
1
Department of Optometry and Occupational Diseases, Faculty of Public Health, Medical University Varna, Varna, BULGARIA
 
2
Department of Neurological Diseases and Neuroscience, Faculty of Medicine, Medical University Varna, Varna, BULGARIA
 
 
Online publication date: 2023-02-03
 
 
Publication date: 2023-05-01
 
 
Electron J Gen Med 2023;20(3):em467
 
KEYWORDS
ABSTRACT
Carbon monoxide (CO) is a colorless, odorless, and lacking in irritative properties gas. It has a higher affinity towards hemoglobin than oxygen and thus the complex carboxyhemoglobin develops. Acute CO poisoning leads to poly-organic insufficiency and the organs that suffer the most are the ones with higher oxygen needs- the brain, the heart and the kidneys. We present a clinical case of 49-year-old woman with a sudden appearance of complaints of dizziness, stiffness throughout the entire body, inability to move. Subsequently she was found by her relatives with disorientated and “foaming around her mouth”. Earlier she had been using a gasoline generator because of a power outage. Her laboratory results came out with higher carboxyhemoglobin (40%), nitrogen waste products and mixed type acidosis. From the conducted brain MRI there were changes, correlating to toxic encephalopathy after acute CO poisoning.
 
REFERENCES (22)
1.
Jarman H, Atkinson RW, Babu A, Moss P. Cross-sectional study of carbon monoxide alarm use in patients attending the emergency department: A multicentre survey protocol. BMJ Open. 2022;12(11):e061202. https://doi.org/10.1136/bmjope... PMid:36385037 PMCid:PMC9670950.
 
2.
Al-Matrouk A, Al-Hemoud A, Al-Hasan M, Alabouh Y, Dashti A, Bojbarah H. Carbon monoxide poisoning in Kuwait: A five-year, retrospective, epidemiological study. Int J Environ Res Public Health. 2021;18(16):8854. https://doi.org/10.3390/ijerph... PMid:34444603 PMCid:PMC8394128.
 
3.
Rose JJ, Wang L, Xu Q, et al. Carbon monoxide poisoning: Pathogenesis, management, and future directions of therapy. Am J Respir Crit Care Med. 2017;195(5):596-606. https://doi.org/10.1164/rccm.2... PMid:27753502 PMCid:PMC5363978.
 
4.
Hanley ME, Patel PH. Carbon monoxide toxicity. Treasure Islands, FL: StatPearls Publishing; 2022.
 
5.
Kim SG, Woo J, Kang GW. A case report on the acute and late complications associated with carbon monoxide poisoning. Medicine (Baltimore). 2019;98(19):e15551. https://doi.org/10.1097/MD.000... PMid:31083215 PMCid:PMC6531082.
 
6.
Oh S, Choi S-C. Acute carbon monoxide poisoning and delayed neurological sequelae: A potential neuroprotection bundle therapy. Neural Regen Res. 2015;10(1):36-8. https://doi.org/10.4103/1673-5... PMid:25788913 PMCid:PMC4357109.
 
7.
Lv Y, Zhang Y, Pan S. Brain stem and spinal cord demyelination due to acute carbon monoxide poisoning. Undersea Hyperb Med. 2021;48(3):247-53. https://doi.org/10.22462/05.06... PMid:34390629.
 
8.
Garg J, Krishnamoorthy P, Palaniswamy C, et al. Cardiovascular abnormalities in carbon monoxide poisoning. Am J Ther. 2018;25(3):e339-48. https://doi.org/10.1097/MJT.00... PMid:24518173.
 
9.
Ipek S, Gullu UU, Gungor S, Demiray S. The effect of full blood count and cardiac biomarkers on prognosis in carbon monoxide poisoning in children. Ir J Med Sci. 2022;1-10. https://doi.org/10.1007/s11845... PMid:36445626 PMCid:PMC9707252.
 
10.
Haliga RE, Morărașu BC, Șorodoc V, etal. Rare causes of acute coronary syndrome: Carbon monoxide poisoning. Life (Basel). 2022;12(8):1158. https://doi.org/10.3390/life12... PMid:36013337 PMCid:PMC9410220.
 
11.
Olatunde O, Raj V, Tambe V, Szombathy T. Carbon monoxide poisoning and its effect on QTc prolongation. J Cardiol Cases. 2020;22(1):19-21. https://doi.org/10.1016/j.jcca... PMid:32636963 PMCid:PMC7326656.
 
12.
Chiew AL, Buckley NA. Carbon monoxide poisoning in the 21st century. Crit Care. 2014;18(2):221. https://doi.org/10.1186/cc1384... PMCid:PMC4057251.
 
13.
Sonmez BM, Iscanli MD, Parlak S, Dogan Y, Ulubay HG, Temel E. Delayed neurologic sequelae of carbon monoxide intoxication. Turk J Emerg Med. 2018;18(4):167-9. https://doi.org/10.1016/j.tjem... PMid:30533561 PMCid:PMC6261102.
 
14.
Tsai P-H, Chou M-C, Chiang S-W, et al. Early white matter injuries in patients with acute carbon monoxide intoxication: A tract-specific diffusion kurtosis imaging study and STROBE compliant article. Medicine (Baltimore). 2017;96(5):e5982. https://doi.org/10.1097/MD.000... PMid:28151889 PMCid:PMC5293452.
 
15.
Halvorson TS, Stauffer SL, JonesKA. An elderly man with bilateral cavitary lesions in the globus pallidus. Brain Pathol. 2022;32(2):e13025. https://doi.org/10.1111/bpa.13... PMid:34786782 PMCid:PMC8877725.
 
16.
Kumarihamy P, Kularatne SAM, Pathirage M, Gunaratne WMSN, Waduge R. A case of delayed neurological manifestation following carbon monoxide poisoning in Sri Lanka: Epidemiology of exposure and literature review. BMC Pharmacol Toxicol. 2019;20(1):17. https://doi.org/10.1186/s40360... PMid:30953563 PMCid:PMC6451287.
 
17.
Huang F, Yang L, Tan Z, et al. Prognostic factors of hyperbaric oxygen therapy for patients with delayed encephalopathy after acute carbon monoxide poisoning. Heliyon. 2022;8(12):e12351. https://doi.org/10.1016/j.heli... PMid:36582705 PMCid:PMC9792756.
 
18.
Zheng H, Liu H, Zhang G, Zhuang J, Li W, Zheng W. Abnormal brain functional network dynamics in acute CO poisoning. Front Neurosci. 2021;15:749887. https://doi.org/10.3389/fnins.... PMid:34867160 PMCid:PMC8636030.
 
19.
Huang Y-Q, Peng Z-R, Huang F-L, Yang A-L. Mechanism of delayed encephalopathy after acute carbon monoxide poisoning. Neural Regen Res. 2020;15(12):2286-95. https://doi.org/10.4103/1673-5... PMid:32594050 PMCid:PMC7749483.
 
20.
Chou M-C, Li J-Y, Lai P-H. Longitudinal white matter changes following carbon monoxide poisoning: A 9-month follow-up voxelwise diffusional kurtosis imaging study. AJNR Am J Neuroradiol. 2019;40(3):478-82. https://doi.org/10.3174/ajnr.A... PMid:30765380 PMCid:PMC7028662.
 
21.
Jeon SB, Sohn CH, Seo D-W, et al. Acute brain lesions on magnetic resonance imaging and delayed neurological sequelae in carbon monoxide poisoning. JAMA Neurol. 2018;75(4):436-43. https://doi.org/10.1001/jamane... PMid:29379952 PMCid:PMC5885203.
 
22.
Bahng Y, Baek K, Park J-T, Choi W-J, Kwak K. Carbon monoxide poisoning and developing ischemic heart disease: A nationwide population-based nested case-control study. Toxics. 2021;9(10):239. https://doi.org/10.3390/toxics... PMid:34678935 PMCid:PMC8540068.
 
eISSN:2516-3507
Journals System - logo
Scroll to top