Veterinary and human toxicology
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Five children with paraquat poisoning are presented. Three were diagnosed early, treated and survived; the other 2 arrived 1-2 days after paraquat ingestion and died subsequently from respiratory failure due to pulmonary fibrosis.
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Secondary to the i.v. administration of a corn-derived dextrose solution, a 23-y-old pregnant female patient admitted to the hospital at term gestation developed an anaphylactic reaction. Orofacial swelling, difficulty in breathing, hypotension, cardiac arrhythmia, voice hoarseness, total body warmth and flushing occurred within 8 min of initiation of a 5% dextrose Lactated Ringer's solution. ⋯ A sample of suspect solution was sent to the manufacturer but no contamination was reported. Although the reaction elicited in this patient was rare, clinicians should be aware of the possibility of corn allergy due to the administration of i.v. fluids containing corn-derived dextrose.
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Case Reports
Effect of inadequate antivenin stores on the medical treatment of crotalid envenomation.
The case of a 27-y-old male with a serious Crotalus atrox envenomation is presented. His medical care was compromised by the lack of readily available polyvalent Crotalidae antivenin. ⋯ Current antivenin stocking was related to antivenin use during the previous year. Reliance on recent antivenin use to guide current antivenin stocking leaves many hospitals with insufficient antivenin stores and may seriously compromise the medical care of patients suffering from rattlesnake envenomations.
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A 1-year prospective study was conducted to identify epidemiological factors associated with caterpillar envenomations. Of 117 envenomations, 112 were included in the study. Identification of the caterpillars involved was accomplished in 68% of the cases. ⋯ No positive correlation could be drawn between allergy history and extent of clinical effect following envenomation. Mild to moderate local response following envenomation was typical. However, 61% of patients evaluated experienced mild to moderate effects at least 24 h post-envenomation.