• Mehrangiz Hatami, Frederick Naftolin, and Masood A Khatamee.
• Department of Obstetrics and Gynecology, School of Medicine, Shaheed Beheshti University of Medical Sciences and Health Services, Evin ST, Shahid Chamran Exp, Way, Tehran, Iran. Mehrangizhatami@yahoo.com.
• J Med Case Rep. 2014 Jan 1;8:263.

IntroductionCarbon monoxide poisoning is a very common cause of death in accidental, suicidal, or homicidal cases throughout the world. Fingernail bed manifestation is reported in survivors of carbon monoxide poisoning.Case PresentationA 40-year-old Caucasian woman was exposed to carbon monoxide when she was sleeping alone in her one-bedroom apartment; fortunately, the beeps from her First Alert combination smoke and carbon monoxide detector woke her and she was saved from any extensive health issues. The most indicative symptoms experienced were a severe headache, blurred vision, agitation, and confusion. Following contact with the Emergency Responses Services, she was promptly transferred to the hospital via ambulance and was treated with high-flow oxygen on the way. She was discharged from the emergency department on the same day, but carbon monoxide exposure had already had adverse effects on her fingernail beds. The fingernail tips were altered and appeared as if a bite had been taken out of their distal borders. The changes in the tips of her fingernails were significant, but they completely disappeared eight weeks later without any additional treatment.ConclusionsWorldwide, carbon monoxide poisoning is a potentially lethal condition that is preventable with educational programs and installation of carbon monoxide detectors in the home setting. Exposure to carbon monoxide frequently goes unrecognized until it is too late and causes silent death. To the best of the authors' knowledge, this is the first report in the literature of fingernail bed manifestations in a survivor of carbon monoxide poisoning.

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