Abstract
OBJECTIVES. Ecstasy poisoning (3,4-methylenedioxymethamphetamine or MDMA) in infants is very rare, only isolated case studies are known from the literature.
METHOD AND PATIENT. The authors present a case of accidental ingestion of ecstasy in an 8-month-old infant in which the clinical picture of the first hour after poisoning was very dramatic: disorders of consciousness, convulsions, agitation, heavy sweating, mydriasis without photoreaction, tachypnoea, life-threatening tachycardia, hypertension, hyperthermia, low O2 saturation (SpO2 83 %).
RESULTS. Symptomatic treatment (physical cooling, Paracetamol i.v., rehydration, oxygen therapy, suppression – Diazepam, Propofol Dexdor, Tisercin i.v.) led to an adjustment in clinical condition within 3 days. Severe tachycardia from 220/min decreased in 7 hours at 120/min, but values 140 – 180/min persisted for another day. Hypertension 139/69 mmHg decreased within 3 hours at 104/59 mmHg, but age-appropriate values were not until the next day. The fever decreased within 5 hours at 37.5 °C, but in the further course intermittently varied up to 38.5 °C. On the second day there was significant malaise, which improved until the 3rd day.
CONCLUSION. The presumed ecstasy poisoning was confirmed by a toxicological examination. The case highlights the need to consider the possibility of accidental use of Ecstasy in the differential diagnosis of a child with fever and sudden impairment of consciousness and convulsions (Ref. 10). Text in PDF www.lekarskyobzor.sk.
KEY WORDS: ecstasy poisoning, disorders of consciousness, convulsions.
Lek obz 2022, 71 (8): 309-312
Tibor ŠAGÁT 1, Rudolf RIEDEL 1, Barbora NEDOMOVÁ 1, Miroslava KURILOVÁ 1, Ľudmila PODRACKÁ 2 , Marcel BRENNER 3, Silvia PLAČKOVÁ 4
1 Detská klinika anestéziológie a intenzívnej medicíny LF SZU a NÚDCH Bratislava, prednosta MUDr. R. Riedel, PhD.
2 Detská klinika LF UK a NÚDCH Bratislava, prednostka prof. MUDr. Ľ. Podracká, PhD.
3 Oddelenie urgentného príjmu NÚDCH Bratislava, primár MUDr. M. Brenner
4 Národné toxikologické informačné centrum, ÚNB, Bratislava, vedúca MUDr. S. Plačková, PhD.
Cite:
AGÁT T., RIEDEL R., NEDOMOVÁ B., KURILOVÁ M., PODRACKÁ Ľ., BRENNER M., PLAČKOVÁ S.: Severe ecstasy poisoning in an 8-month-old infant. Lek obz 2022, 71 (8): 309-312
