Allergic to bismuth salts

Introduction Poisoning a large amount, excessive medical use or long-term application of tincture can cause poisoning. Bismuthpoisoning is mostly caused by the application of a large amount of bismuth nitrate in the treatment of diarrhea. Due to the action of intestinal bacteria, bismuth subnitrate can be oxidized to nitrite, so symptoms of bismuth and nitrite double poisoning can occur. The lethal dose of oral bismuth subnitrate in children is about 3 to 5 g. Excessive intravenous or intramuscular soluble strontium salts can cause acute poisoning. Insoluble strontium salts (such as barium hypocarbonate) are often used as internal or external preparations for the treatment of gastrointestinal diseases. Although they are rarely absorbed, they can cause sputum poisoning if used in large quantities or in long-term applications. Lactating women repeatedly apply cod liver oil sputum due to rupture of the nipple, and infants may cause poisoning due to intrusion. For those who are allergic to strontium salt, fever, rash, acute hemolysis may occur after intramuscular injection, and occasional exfoliative dermatitis may occur.

Cause

Inorganic strontium salts such as bismuth subnitrate, bismuth subgallate or compound lead bismuth (stomach must be treated with 200 mg of barium aluminate per tablet), if taken in excess, may be poisoned by an increase in blood sputum concentration, causing encephalopathy.

an examination

Related inspection

Skin color skin smear microscopy mammography

Acute poisoning is mainly due to oral entry. The sick child may have nausea, vomiting, salivation, pain in the tongue and throat, abdominal pain, diarrhea, black stool, blood, skin and mucous membrane bleeding, headache, convulsions, etc. Due to liver and kidney damage, it can cause liver enlargement, jaundice, protein and cast in urine, and even acute liver and kidney failure. Applying a large amount of bismuth nitrite, symptoms of nitrite poisoning, such as dizziness, flushing, pulse rate, chest pressure, dyspnea, and purpura caused by methemoglobinemia; severe illness due to heart and blood vessel palsy, Blood pressure lowering, shock, etc. can occur. The encephalopathy caused by poisoning such as gallic acid, barium carbonate, and barium silicate has headaches, insomnia, and mental disorders. Later, obvious symptoms of encephalopathy such as confusion, muscle rigidity, and movement disorders may occur suddenly. , dysarthria, hallucinations, horror, etc.

For those who are allergic to strontium salt, fever, rash, acute hemolysis may occur after intramuscular injection, and occasional exfoliative dermatitis may occur. Long-term use of tincture can cause polyneuritis, stomatitis, swelling of the gums, pigmentation of the oral mucosa and black lines on the gums. X-ray films of the long bones of the patient showed white bands, similar to those seen in lead poisoning cases.

Differential diagnosis

It is differentiated from other drug poisonings that can cause symptoms such as encephalopathy and renal failure.

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