Question

Salicylate poisoning: 
Clinical manifestations. 
 

Hint:

Early symptoms like tinnitus and gastrointestinal distress should raise suspicion of salicylate poisoning, especially in children or patients with a known history of aspirin use.

Answer 1

Step 1: Initial Symptoms of Salicylate Poisoning.
1. Gastrointestinal symptoms: Nausea, vomiting, and abdominal pain are common early symptoms of salicylate toxicity.
2. Respiratory symptoms: Hyperventilation, tachypnea, and respiratory alkalosis due to the stimulation of the respiratory center in the brain.
3. Neurological symptoms: Tinnitus (ringing in the ears) is a hallmark sign of salicylate toxicity, along with dizziness, confusion, and agitation.
4. Metabolic changes: Fever and sweating due to increased metabolic rate.

Step 2: Severe Symptoms and Complications.
1. Altered mental status: Severe poisoning can lead to drowsiness, delirium, seizures, and even coma.
2. Cardiovascular instability: Hypotension, tachycardia, and arrhythmias can occur in severe cases.
3. Renal failure: Acute renal failure can result from dehydration, hypovolemia, and tubular necrosis.

Step 3: Conclusion.
Clinical manifestations of salicylate poisoning range from gastrointestinal symptoms and respiratory alkalosis to neurological and cardiovascular instability in severe cases. Early recognition and treatment are crucial to prevent life-threatening complications.