Food poisoning in patients with diabetes mellitus

The clinical picture of food toxoinfections in patients with diabetes mellitus is characterized by a more severe and protracted course. On the other hand, food toxoinfections promote diabetes mellitus decompensation and the development of diabetic ketoacidosis. Since diabetes mellitus and food toxoinfections have a number of symptoms in common the authors suggest the diagnostic working schedule. Grave and medium-grave food toxoinfections in patients with diabetes mellitus mandate refusing the intake of oral antidiabetic drugs and long-acting insulins. It is recommended that insulin may be administered in divided doses.     

Food poisoning associated methemoglobinemia: Time to wake up

Dear editor,With interest we read the recent article on methemoglobinemia by Chan et al.[1]Through this letter,we would like to add few additional comments regarding methemoglobinemia and its relevance in medicine practice with regards to food poisoning.While Chan et al[1]successfully managed their patient of methemoglobinemia and could pinpoint choy sum as the responsible agent,we wonder if there were any more cases of choy sum related to methemoglobinemia detected at the same time in the community?     

白假丝酵母菌致食物中毒的病原学鉴定及药敏试验结果的报告

目的明确白假丝酵母菌的鉴定过程,探寻治疗白假丝酵母菌致食物中毒的药物。方法收集16例食物中毒者吐、泻物标本及剩余饭菜,酱油。白假丝酵母菌的鉴定用快速微生物鉴定系统(API)20C Aux V3.0;药敏试验用FUNGUS-11药敏最低抑菌浓度(MIC)测定试验条。结果检样呕吐物、水样便、剩菜、酱油中检出白假丝酵母菌,食物中毒主要是白假丝酵母菌引起的,白假丝酵母菌对两性霉素B和制霉菌素敏感。结论综合流行病学调查、临床症状、实验室鉴定结果,确定该次食物中毒由白假丝酵母菌引起;首选治疗药物为两性霉素B和制霉菌素。     

Paracetamol poisoning

Paracetamol is a common cause of fatal self-poisoning in the UK every year. Despite this, it continues to be sold freely without medical supervision and can be found in quantity in most household medicine cabinets.     

Colchicine poisoning

Colchicine poisoning is an unusual but serious form of drug intoxication. Although relatively uncommon, colchicine poisoning may produce life-threatening systemic effects that must be recognized and treated by the emergency physician. This alkaloid found in Cokhicum autumnale is used primarily in the treatment of gout. In toxic doses it produces nausea and vomiting, and bone marrow suppression often leading to sepsis, hypocalcemia, adult respiratory distress syndrome, and direct cardiotoxic effects. Treatment requires early recognition and supportive care including fluid and electrolyte replacement and occasionally blood component replacement therapy. Recent experiments using colchicine-specific antibodies have demonstrated beneficial effects on colchicine intoxication.     

Scombroid poisoning

The symptoms of scombroid poisoning resemble an acute allergic reaction. Tuna, albacore, mackerel and bonito are implicated, as are nonscombroid fish such as mahi-mahi and bluefish. The histamine content of affected fish is high, but the pathophysiology is more complex than the mere ingestion of histamine. Antihistamines and cimetidine appear to be effective in controlling symptoms. Prevention consists of prompt and adequate refrigeration of dark-meated fish.     

Methanol poisoning

Preview

The stereotypical case of methanol poisoning involves adulterated “moonshine” or “bathtub gin.” But did you know that it can also result from using photocopying diluent as an alcoholic beverage? Or that it can follow respiratory or dermal exposure? Dr Haines describes how to recognize and treat this deadly intoxication in its various manifestations.     

Methotrexate poisoning

Three case studies of accidental methotrexate ingestion in paediatric patients are presented. Two patients had toxic methotrexate levels. Treatment included the administration of charcoal, intravenous hydration, alkalinisation of urine and the administration of the specific antidote folinic acid. All patients made an uneventful recovery. Parenteral folinic acid therapy should be commenced without delay in all cases of suspected methotrexate poisoning in equimolar concentration to the suspected dose of methotrexate. It is recommended that methotrexate tablet packaging be altered to reduce the likelihood of paediatric access.