Kakimoto Kohei, Hikone Mayu, Sugiyama Kazuhiro
Tertiary Emergency Medical Center (Trauma and Critical Care) Tokyo Metropolitan Bokutoh Hospital Tokyo Japan.
Acute Med Surg. 2023 Jun 16;10(1):e859. doi: 10.1002/ams2.859. eCollection 2023 Jan-Dec.
We report a case of disulfiram overdose that caused a delayed onset of impaired consciousness and ketoacidosis.
A 61-year-old man was transferred to our hospital following a suicide attempt. The patient lost consciousness after an overdose of disulfiram and brotizolam. He was diagnosed with acute drug intoxication and was intubated. On day 2, he showed an improved consciousness response and was successfully extubated. On day 5, the state of consciousness worsened again, and ketoacidosis progressed. The patient required hemodialysis and suffered from impaired consciousness for the following 2 weeks. Eventually, he recovered gradually and was discharged to the rehabilitation ward.
The delayed appearance of symptoms after the disulfiram overdose was thought to be related to the slow metabolism of disulfiram in the body. Our case suggests the necessity of careful follow-up for delayed impaired consciousness.
我们报告一例双硫仑过量导致意识障碍和酮症酸中毒延迟发作的病例。
一名61岁男性在自杀未遂后被转至我院。该患者在过量服用双硫仑和溴替唑仑后失去意识。他被诊断为急性药物中毒并接受了插管。第2天，他的意识反应有所改善并成功拔管。第5天，意识状态再次恶化，酮症酸中毒进展。患者需要进行血液透析，并在接下来的2周内一直存在意识障碍。最终，他逐渐康复并被转至康复病房。
双硫仑过量后症状延迟出现被认为与双硫仑在体内代谢缓慢有关。我们的病例提示有必要对延迟出现的意识障碍进行密切随访。
