15 February 2020 : Case report
A Case of Salicylate Toxicity Presenting with Acute Focal Neurologic Deficit in a 61-Year-Old Woman with a History of Stroke
Unknown etiology, Challenging differential diagnosis, Unexpected drug reactionTessa M. Delaney1ABEF, Jason T. Helvey2BDE, Jason F. Shiffermiller3ABEF*
Am J Case Rep 2020; 21:e920016
BACKGROUND: Over-the-counter medications that contain aspirin are widely used, and patients generally regard them as safe. However, the side effects of salicylate toxicity can be severe, and delay in the diagnosis may increase the risk of mortality. Neurologic symptoms are a common presenting feature of salicylate toxicity in the elderly, and their recognition may allow earlier diagnosis. This report is of a case of a 61-year-old woman who presented with acute focal neurologic deficit associated with salicylate toxicity and who had a previous history of stroke.
CASE REPORT: A 61-year-old woman presented to the Emergency Department after awakening with left-sided weakness. She had a history of ischemic stroke with an associated seizure disorder. The patient denied recent seizure, and brain magnetic resonance imaging (MRI) showed no evidence of an acute stroke. Following her arrival, she became acutely confused and complained of tinnitus, shortness of breath, and blurred vision. On direct questioning, she gave a history of excessive use of salicylate for the previous two to three weeks. Her initial serum salicylate level was significantly increased at 78.1 mg/dl (upper therapeutic limit, 19.9 mg/dl). She recovered completely following treatment with oral activated charcoal, intravenous sodium bicarbonate, and potassium replacement.
CONCLUSIONS: This case demonstrates that physicians should consider salicylate toxicity as a possible cause of exacerbation of neurological deficit in elderly patients.
Keywords: Acid-Base Imbalance, Neurotoxicity Syndromes, Salicylates, Charcoal, Delirium, Neurologic Examination, Paresis, Potassium, Sodium Bicarbonate, Stroke, Tinnitus
09 Jan 2024 : Case reportChallenges of Post-Venipuncture Jugular Venous Thrombosis in Patients with Secondary Hyperparathyroidism: A...
Am J Case Rep In Press; DOI: 10.12659/AJCR.943270
09 Jan 2024 : Case reportNeurotrophic Keratopathy in Marfan Syndrome Patient After Micropulse Transscleral Cyclophotocoagulation: A ...
Am J Case Rep In Press; DOI: 10.12659/AJCR.942538
03 Feb 2024 : Case reportDefinitive Closure Using an Ovine Reinforced Tissue Matrix in Contaminated Penetrating Abdominal Trauma
Am J Case Rep In Press; DOI: 10.12659/AJCR.943188
Most Viewed Current Articles
10 Jan 2022 : Case reportA Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...
Am J Case Rep 2022; 23:e935263
19 Jul 2022 : Case reportAtlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19
Am J Case Rep 2022; 23:e936128
05 Mar 2022 : Case reportAcute Limb Ischemia After Self-Injection of Crushed Morphine Tablets into the Radial Artery: Role of Infrar...
Am J Case Rep 2022; 23:e935336