Acta toxicológica argentina
On-line version ISSN 1851-3743
DI NARDO, Victoria A; CORTESE, Silvia; RISSO, Marina and DAMIN, Carlos. Acute lung injury due to acetylsalicylic acid poisoning: Case report and review. Acta toxicol. argent. [online]. 2012, vol.20, n.1, pp. 25-33. ISSN 1851-3743.
Salicylate intoxication is frequently overlooked as a cause of noncardiogenic pulmonary edema and altered mental status in adult patients. We described the case of a 52 years-old woman who presented two episodes of recurrent non-cardiogenic pulmonary edema requiring intubation. On admission, recognition of the clinical syndrome in the emergency department led to the correct diagnosis of salicylate intoxication. The patient was successfully treated with hemodialysis and urinary alkalinization, leading to rapid resolution of pulmonary edema and extubation. Several aspects of the clinical presentation suggest that the patient suffered from chronic salicylism, a condition often misdiagnosed or diagnosed late in the course of disease, contributing to substantial morbidity and mortality in these patients. This poisoning should be considered in the differential diagnosis of acute pulmonary edema not cardiogenic and altered sensorium because rapid institution of appropriate therapy, including hemodialysis, once the diagnosis is established is an important determinant of outcome in this serious disorder.
Keywords : Intoxication; Salicylate; Pulmonary edema; Hemodialysis.