A case of acute cyanide poisoning treated with hydroxocobalamin

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  • ヒドロキソコバラミン投与で治療したシアン中毒の1例

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A 34-year-old male with schizophrenia ingested gold (I) potassium cyanide at his office. He thereafter presented at the emergency department with nausea, vomiting, and abdominal pain. He was conscious, and his vital signs were stable upon admission, however, convulsions were observed in the right upper part of his body. We therefore diagnosed him to have cyanide poisoning based on information obtained from the patient who was still conscious. Sodium nitrite and sodium thiosulfate were administrated immediately. His condition deteriorated, and hyperlactatemia progressed, in spite of the administration of these two drugs. Hypoxia and hyperlactatemia also progressed. As a result, the patient was intubated and treated with hydroxocobalamin. Dimercaprol was also administered because the consumed poison contained gold. Following these treatments, the patient's condition improved. He was extubated on the 2nd hospital day and showed a good recovery. Thereafter, he was moved to another hospital to receive treatment for his schizophrenia. We experienced a case of cyanide poisoing which is rare in Japan. We report this case while focusing on the appropriate antidotes that should be administered to such patients.

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