Nantel A J, Brown M, Dery P, Lefebvre M
Vet Hum Toxicol. 1985 Dec;27(6):531-3.
A 2 yo male child ingested approximately 15 ml of a Gun Blue solution containing selenious acid, nitric acid and copper nitrate. He was immediately given milk and vomited spontaneously blood-stained food with a garlic smell. He was admitted to our Centre less than 3 hr following ingestion. An esophago-gastroscopy showed a second degree burn of both esophagus and stomach. He became comatose and had to be ventilated mechanically. Metabolic acidosis, leucocytosis, hyperglycemia and hemoconcentration were also observed. During the following day he developed a severe intestinal distension, a cardiomyopathy (CPK = 1,302, cardiac arrhythmia), and moderate hepatic, renal and pulmonary dysfunctions. Plasma selenium concentration was 285 micrograms/L and the maximum urinary concentration was 28,459 micrograms/L. After 4 days, his condition had improved considerably and he was about to be extubated when he suddenly developed acute respiratory distress. A similar episode occurred 24 hr later. His lung function progressively deteriorated; later he required the use of an extracorporeal membrane lung. Legionella dumofii was found the causative agent. He died 17 d after ingestion despite aggressive treatment. Acute selenious acid poisoning and its relation to Legionnaire's disease is discussed.
一名2岁男童摄入了约15毫升含亚硒酸、硝酸和硝酸铜的枪蓝色溶液。他立即被给予牛奶，并自发呕吐出带血且有大蒜味的食物。摄入后不到3小时，他被送往我们中心。食管胃镜检查显示食管和胃均有二度烧伤。他陷入昏迷，不得不进行机械通气。还观察到代谢性酸中毒、白细胞增多、高血糖和血液浓缩。在接下来的一天里，他出现了严重的肠扩张、心肌病（肌酸磷酸激酶=1302，心律失常），以及中度的肝、肾和肺功能障碍。血浆硒浓度为285微克/升，尿中最高浓度为28459微克/升。4天后，他的病情有了很大改善，即将拔管时突然出现急性呼吸窘迫。24小时后发生了类似情况。他的肺功能逐渐恶化；后来他需要使用体外膜肺。发现杜莫菲军团菌是病原体。尽管进行了积极治疗，他在摄入后17天死亡。本文讨论了急性亚硒酸中毒及其与军团病的关系。
