A 2yr old child was brought to ER after drinking a disinfectant liquid. On examination, he was in coma, pupils constricted, pulse 120/min; respiratory rate:-40/min, urine was few and it&;s colour changed to green on exposure to air. What is the diagnosis
Correct Answer: Carbolic acid
Description: CARBOLIC ACID (phenol; OH) Systemic Effects:- Phenol is a depressant of the nervous system, especially the respiratory centre. Headache, giddiness, unconsciousness and coma occur. The temperature is subnormal, the pupils are contracted, breathing is steorous, pulse is rapid, feeble and irregular, face covered with cold sweat, and there is dusky cyanosis, respiratory alkalosis and metabolic acidosis. Liver may be damaged. In severe cases haemolysis and methaemoglobinaemia is a characteristic feature. There is a strong odour of phenol in breath. Convulsions and lock-jaw sometimes occur. Urine:- It is scanty and contains albumin and free haemoglobin; suppression may follow. It may be colourless or slightly green at first, but turns green or even black on exposure to air. In the body, phenol is paly oxidised to hydroquinone and pyrocatechol, which with unchanged phenol are excreted in the urine, paly free, and paly in unstable combination with sulphuric and glucoronic acids. The fuher oxidation of hydroquinone and pyrocatechol in the urine is the cause of green colouration. This is known as carboluria. Ref:- k s narayan reddy; pg num:-534,535
Category:
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