Cases TBA

Cases TBA

Opioids + Neurotoxicity

Cases TBA

Perils of the Unexpected: Toxic Encounters in Animals, Industry, and the Environment

Case 1: A 42-year-old woman with opioid use disorder and sedative use disorder presents to the ED with mild opioid withdrawal, for which she receives methadone and diazepam. Her initial vital signs are: BP, 115/76; RR, 17; HR, 63; T, 97.5 F. Six hours after arrival she becomes acutely diaphoretic and tremulous, with a COWS of 30 and the following vitals: BP, 203/100; HR, 144. /// Case 2: A 69-year-old woman with multiple medical comorbidities including type 2 diabetes mellitus and coronary artery disease presents with worsening fatigue, anorexia, nausea, and vomiting after recently starting isoniazid for a positive test with no active symptoms. /// Case 3: A 39-year-old man presents after a supratherapeutic acetaminophen exposure. He receives NAC and during hospitalization is noted to develop hyperbilirubinemia and anemia.

Case 1: A 6-month-old boy presents with anticholinergic findings after his father inadvertently administered an incorrect medication. Advanced toxicological testing detects an unexpected opioid. / Case 2: A 29-year-old man with polysubstance use disorder, including opioids and benzodiazepines, presents with abdominal pain, nausea, vomiting. After treatment for withdrawal, he develops SVT and ultimately a core temperature of 105F. / Case 3: A 45-year-old man with a history of hepatic transplant for autoimmune hepatitis presents with multiple seizures after a self-harm attempt.

Case 1: A 15-year-old girl with epilepsy comes to the ED with increased seizure activity and has an unexpected laboratory finding. / Case 2: A 75-year-old man with a complicated medical history presents with two weeks of rapid cognitive decline, gait instability, dizziness, dysmetria, hallucinations, and persistent encephalopathy. / Case 3: A 27-year-old man presents to the ED following ingestion of a product he purchased online with numbness in the fingers, foaming at the mouth, tachycardia, and hypotension.

Case 1: A 7-month-old girl is admitted after experiencing 2 weeks of upper respiratory symptoms. She has some mild language and motor delay and has a seizure on hospital day 4. Case 2: A 21-year-old woman develops shock four hours after overdosing on vitamins she purchased online. Case 3: A 43 year-old man presents for first-time psychosis and states he self-medicated his opioid withdrawal with OTC products one day prior. He develops rapidly worsening agitation, encephalopathy, tachycardia, and psychosis and requires sedation.

Case 1: A 30-year-old woman presents to the ED with a rash that started after she took a medication to treat a toothache. On arrival to the ED she is febrile and tachycardic. Case 2:​ A 62-year-old woman is found unresponsive and covered in vomit. On arrival to the ED, she is obtunded, hypothermic, and hypotensive. Case 3: ​A 3-year-old boy with developmental delay is found playing with a common household object. When his father realizes he has ingested almost half of it, he washes out the child’s mouth and brings him to the ED.