双硫仑过量后意识障碍延迟出现并伴有酮症酸中毒。

Delayed onset of impaired consciousness complicated with ketoacidosis after disulfiram overdose.

作者信息

Kakimoto Kohei, Hikone Mayu, Sugiyama Kazuhiro

机构信息

Tertiary Emergency Medical Center (Trauma and Critical Care) Tokyo Metropolitan Bokutoh Hospital Tokyo Japan.

出版信息

Acute Med Surg. 2023 Jun 16;10(1):e859. doi: 10.1002/ams2.859. eCollection 2023 Jan-Dec.

DOI:10.1002/ams2.859

PMID:37333950

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10276189/

Abstract

BACKGROUND

We report a case of disulfiram overdose that caused a delayed onset of impaired consciousness and ketoacidosis.

CASE PRESENTATION

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.

CONCLUSIONS

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.

摘要