Shabani Minoosh, Nasiri Maryam, Aminzadeh Zohreh, Hassanian Moghaddam Hossein
Infectious Diseases and Tropical Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Iran J Med Sci. 2019 Mar;44(2):168-171.
Although lead pollution has long been known as a cause of poisoning, it has remained a challenge to reliably diagnose it due to its common symptoms in various diseases. In this article, we report two cases of acute loss of consciousness due to the ingestion of opium-contaminated with lead. The reported cases share patterns of symptoms similar to meningitis and encephalitis which are usual etiology for the loss of consciousness. Lead poisoning is not a usual etiology for loss of consciousness and is considered in cases of occupational or environmental exposure. These reported cases showed a pattern similar to meningitis and encephalitis, but due to the unusual manifestations during their admission and coexistence with gastrointestinal symptoms, we were led to consider poisoning as the cause of consciousness loss. Lead poisoning often goes unrecognized due to a low index of suspicion, but it may turn out to be fatal. Therefore, it should be considered in the differential diagnosis of any neurobehavioral deficits in substance abusers.
尽管长期以来人们都知道铅污染是中毒的一个原因，但由于其在各种疾病中都有常见症状，可靠诊断铅中毒仍然是一个挑战。在本文中，我们报告了两例因摄入受铅污染的鸦片而导致急性意识丧失的病例。报告的病例具有与脑膜炎和脑炎相似的症状模式，而脑膜炎和脑炎是意识丧失的常见病因。铅中毒并非意识丧失的常见病因，通常在职业或环境暴露的情况下才会考虑。这些报告的病例表现出与脑膜炎和脑炎相似的模式，但由于入院时表现异常且伴有胃肠道症状，我们开始考虑中毒是意识丧失的原因。由于怀疑指数较低，铅中毒常常未被识别，但它可能是致命的。因此，在对药物滥用者的任何神经行为缺陷进行鉴别诊断时都应考虑到铅中毒。
