A Chemist with a Strange Etiology of Rhabdomyolysis: A Case Report of a Rare Toxicological Emergency

Introduction: Chloroform, a halogenated hydrocarbon, causes central nervous depression, hepatotoxicity, nephrotoxicity, and rhabdomyolysis. Historically, chloroform had been used as a general anaesthetic and today is still used in chemical industries. Lack of proper personal protective equipment and...

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Autores principales:	Rajadurai Meenakshisundaram, Joshua Vijay Joseph, Prabakaran Perumal, Akmal Areeb, Prathap Pancheti, Dinesh Kannan Sampath, Esther Monica Jared
Formato:	article
Lenguaje:	EN
Publicado:	eScholarship Publishing, University of California 2021
Materias:	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
Acceso en línea:	https://doaj.org/article/c442485d218e4f048507ae730a92f3a9
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spelling	oai:doaj.org-article:c442485d218e4f048507ae730a92f3a92021-11-23T20:02:52ZA Chemist with a Strange Etiology of Rhabdomyolysis: A Case Report of a Rare Toxicological Emergency2474-252X10.5811/cpcem.2021.7.52923https://doaj.org/article/c442485d218e4f048507ae730a92f3a92021-11-01T00:00:00Zhttps://escholarship.org/uc/item/8kn0j1x3https://doaj.org/toc/2474-252XIntroduction: Chloroform, a halogenated hydrocarbon, causes central nervous depression, hepatotoxicity, nephrotoxicity, and rhabdomyolysis. Historically, chloroform had been used as a general anaesthetic and today is still used in chemical industries. Lack of proper personal protective equipment and adequate knowledge about its toxic effects can lead to serious harm. Case report: A 33-year-old gentleman presented to the emergency department (ED) with altered mental status. Given his depressed mental status, the decision was made to intubate shortly after arrival for airway protection. Further history raised suspicion of occupational chloroform exposure. Brown-colored urine further strengthened suspicion of chloroform poisoning with resultant rhabdomyolysis. Forced alkaline diuresis and N-acetylcysteine were started in the ED. His mental status and respiratory efforts improved on hospital day two, and he was ultimately extubated. Creatine phosphokinase and myoglobin levels were initially high but gradually came down by hospital day six. On hospital day 10, the patient was deemed stable and safely discharged. Conclusion: A patient with chloroform inhalation who suffered resultant rhabdomyolysis and hepatotoxicity was successfully treated with early initiation of forced alkaline diuresis, N-acetylysteine, and hemodialysis.Rajadurai MeenakshisundaramJoshua Vijay JosephPrabakaran PerumalAkmal AreebPrathap PanchetiDinesh Kannan SampathEsther Monica JaredeScholarship Publishing, University of CaliforniaarticleMedical emergencies. Critical care. Intensive care. First aidRC86-88.9ENClinical Practice and Cases in Emergency Medicine, Vol 5, Iss 4 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9
spellingShingle	Medical emergencies. Critical care. Intensive care. First aid RC86-88.9 Rajadurai Meenakshisundaram Joshua Vijay Joseph Prabakaran Perumal Akmal Areeb Prathap Pancheti Dinesh Kannan Sampath Esther Monica Jared A Chemist with a Strange Etiology of Rhabdomyolysis: A Case Report of a Rare Toxicological Emergency
description	Introduction: Chloroform, a halogenated hydrocarbon, causes central nervous depression, hepatotoxicity, nephrotoxicity, and rhabdomyolysis. Historically, chloroform had been used as a general anaesthetic and today is still used in chemical industries. Lack of proper personal protective equipment and adequate knowledge about its toxic effects can lead to serious harm. Case report: A 33-year-old gentleman presented to the emergency department (ED) with altered mental status. Given his depressed mental status, the decision was made to intubate shortly after arrival for airway protection. Further history raised suspicion of occupational chloroform exposure. Brown-colored urine further strengthened suspicion of chloroform poisoning with resultant rhabdomyolysis. Forced alkaline diuresis and N-acetylcysteine were started in the ED. His mental status and respiratory efforts improved on hospital day two, and he was ultimately extubated. Creatine phosphokinase and myoglobin levels were initially high but gradually came down by hospital day six. On hospital day 10, the patient was deemed stable and safely discharged. Conclusion: A patient with chloroform inhalation who suffered resultant rhabdomyolysis and hepatotoxicity was successfully treated with early initiation of forced alkaline diuresis, N-acetylysteine, and hemodialysis.
format	article
author	Rajadurai Meenakshisundaram Joshua Vijay Joseph Prabakaran Perumal Akmal Areeb Prathap Pancheti Dinesh Kannan Sampath Esther Monica Jared
author_facet	Rajadurai Meenakshisundaram Joshua Vijay Joseph Prabakaran Perumal Akmal Areeb Prathap Pancheti Dinesh Kannan Sampath Esther Monica Jared
author_sort	Rajadurai Meenakshisundaram
title	A Chemist with a Strange Etiology of Rhabdomyolysis: A Case Report of a Rare Toxicological Emergency
title_short	A Chemist with a Strange Etiology of Rhabdomyolysis: A Case Report of a Rare Toxicological Emergency
title_full	A Chemist with a Strange Etiology of Rhabdomyolysis: A Case Report of a Rare Toxicological Emergency
title_fullStr	A Chemist with a Strange Etiology of Rhabdomyolysis: A Case Report of a Rare Toxicological Emergency
title_full_unstemmed	A Chemist with a Strange Etiology of Rhabdomyolysis: A Case Report of a Rare Toxicological Emergency
title_sort	chemist with a strange etiology of rhabdomyolysis: a case report of a rare toxicological emergency
publisher	eScholarship Publishing, University of California
publishDate	2021
url	https://doaj.org/article/c442485d218e4f048507ae730a92f3a9
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A Chemist with a Strange Etiology of Rhabdomyolysis: A Case Report of a Rare Toxicological Emergency

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