Rodrigues Alessi Mateus, Malheiros Ribas Thiago, Setti Campelo Victor, Mauer Sivan
School of Medicine, Universidade Positivo, Curitiba, BRA.
Internal Medicine, Faculdade Evangélica Mackenzie do Paraná, Curitiba, BRA.
Cureus. 2024 Oct 22;16(10):e72128. doi: 10.7759/cureus.72128. eCollection 2024 Oct.
Cocaine intoxication presents a significant public health concern globally, with its use widespread in various regions. This case report outlines the challenging management of a 30-year-old male who presented with acute cocaine intoxication, leading to multiple organ failure and eventual death. The patient exhibited classic symptoms of cocaine intoxication preceding a fall, resulting in severe injuries. Despite aggressive resuscitative measures, the patient deteriorated rapidly, developing rhabdomyolysis, disseminated intravascular coagulation, acute kidney injury, and acute myocardial infarction. Differential diagnoses were considered, ruling out other possible causes. The patient's condition continued to worsen despite treatment, ultimately culminating in cardiac arrest and demise. This case underscores the complexity of managing acute cocaine intoxication and assessing many differential diagnoses, highlighting the importance of early recognition and aggressive intervention to mitigate adverse outcomes. In patients with altered mental status and hemodynamic instability, particularly in areas where drug use is common, cocaine intoxication should be considered as a possible cause.
可卡因中毒是一个全球性的重大公共卫生问题,其使用在各个地区都很普遍。本病例报告概述了一名30岁男性急性可卡因中毒的挑战性治疗过程,该患者出现多器官功能衰竭并最终死亡。患者在跌倒前表现出可卡因中毒的典型症状,导致严重受伤。尽管采取了积极的复苏措施,患者病情迅速恶化,出现横纹肌溶解、弥散性血管内凝血、急性肾损伤和急性心肌梗死。考虑了鉴别诊断,排除了其他可能的原因。尽管进行了治疗,患者的病情仍继续恶化,最终导致心脏骤停和死亡。本病例强调了处理急性可卡因中毒和评估多种鉴别诊断的复杂性,突出了早期识别和积极干预以减轻不良后果的重要性。在精神状态改变和血流动力学不稳定的患者中,特别是在药物使用普遍的地区,应考虑可卡因中毒是可能的原因。