Publication: Successful treatment of lethal cyanide ingestion by sodium thiosulfate alone: Case report
Issued Date
2018-08-01
Resource Type
ISSN
01252208
Other identifier(s)
2-s2.0-85052215263
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand. Vol.101, No.8 (2018), 1139-1142
Suggested Citation
Thanjira Jiranantakan, Summon Chomchai, Paiboon Tummarintra Successful treatment of lethal cyanide ingestion by sodium thiosulfate alone: Case report. Journal of the Medical Association of Thailand. Vol.101, No.8 (2018), 1139-1142. Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/46444
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Successful treatment of lethal cyanide ingestion by sodium thiosulfate alone: Case report
Other Contributor(s)
Abstract
© 2018, Medical Association of Thailand. All rights reserved. Background: Ingestion of cyanide may not manifest immediately in acute life-threatening symptoms. This delay presents an opportunity for recognition and appropriate management. Case Report: A 23-year-old male purchased sodium cyanide through an internet order for suicidal gesture. He mixed sodium cyanide (5 grams) with cola soft drink (350 mL) to produce hydrogen cyanide. The patient inhaled cyanide gas for 30 minutes, however, he did not lose consciousness. He then drank the entire solution, causing him to vomit. The patient presented to the emergency medicine department about two hours after ingestion. He was conscious, and his vital signs were normal. Blood chemistries revealed wide anion gap metabolic acidosis (anion gap 16 mmol/L). Arterial blood gas and venous blood gas on arrival demonstrated no acidosis but narrow arterial and venous oxygen saturation gap (3%). He was treated with 12.5 grams of sodium thiosulfate intravenously, 50 grams of activated charcoal administered orally, and other supportive care. The patient condition improved clinically and laboratory. The narrow arterial-venous oxygen saturation gap was resolved (52%) at four hours post treatment. Hydrogen cyanide levels in patient’s plasma and urine samples were confirmed by Gas Chromatography Mass Spectrometry methods. Conclusion: The patient was a confirmed case of acute cyanide poisoning, exhibiting the early signs of cyanide poisoning, and was successfully treated with sodium thiosulfate alone.