Carboxyhemoglobin levels in patients with flu-like symptoms |
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| Authors: | M C Dolan T L Haltom G H Barrows C S Short K M Ferriell |
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| Affiliation: | 2. Department of Pathology, University of Louisville School of Medicine, Louisville, Kentucky, USA;3. Emergency Department, University Hospital, Louisville, Kentucky, USA;1. Division of Cardiology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan;2. Department of Rehabilitation Medicine, St. Marianna University Hospital, Kawasaki, Kanagawa, Japan;3. Department of Laboratory Medicine, St. Marianna University School of Medicine, Kawasaki, Kanagawa, Japan;1. Department of Forensic Medicine and Medicolegal Expertises, Jessenius Faculty of Medicine, Comenius University, University Hospital, Martin, Slovak Republic;2. Department of Forensic Medicine, Faculty of Medicine, Charles University, University Hospital, Hradec Kralove, Czech Republic;1. Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan;2. Department of Geriatrics and Gerontology, Chi-Mei Medical Center, Tainan, Taiwan;3. Department of Occupational Medicine, Chi-Mei Medical Center, Tainan, Taiwan;4. Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan;5. Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan;6. Bachelor Program of Senior Service, Southern Taiwan University of Science and Technology, Tainan, Taiwan;7. Department of Biotechnology, Southern Taiwan University of Science and Technology, Tainan, Taiwan;8. Department of Leisure, Recreation, and Tourism Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan;9. Department of Pharmacy, Chia Nan University of Pharmacy and Science, Tainan, Taiwan;10. Department of Emergency Medicine, Taipei Medical University, Tainan, Taiwan;11. Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan, Taiwan |
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| Abstract: | ![]()
Subacute carbon monoxide poisoning is commonly misdiagnosed as an influenza-like viral illness. All patients presenting to the triage nurse at University Hospital with flu-like symptoms during February 1985 were asked to give blood samples for carboxyhemoglobin determination. Fifty-five patients (10% of those eligible) with headache, dizziness, nausea, vomiting, diarrhea, weakness, general malaise, or shortness of breath were enrolled in the study. Carboxyhemoglobin levels ranged from 0 to 21%. Thirteen patients (23.6%) of this self-selected subgroup had carboxyhemoglobin levels greater than or equal to 10%. There was no statistically significant difference in carboxyhemoglobin levels between smokers and nonsmokers. More patients using wood heat had elevated carboxyhemoglobin levels than patients using any other form of heating (P less than .05). No patient with a carboxyhemoglobin level greater than or equal to 10% was diagnosed as having subacute CO poisoning by emergency physicians. Physicians must seek out the possibility of CO toxicity in patients with flu-like illness, particularly in inner-city populations during the heating months. Fundoscopy and COHb levels may be useful in selected cases to correctly diagnose patients and avoid a return to a hazardous environment with potentially fatal consequences. |
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