Presentations of acute phenytoin overdose.
A 15-year-old boy ingested 19.6 g (15 g verifiable) phenytoin sodium approximately four hours before emergency department presentation. The patient survived the suicide attempt with only supportive care, despite the ingestion of 392 mg/kg and a peak serum level of 100.8 micrograms/mL. A wide spectrum of physical findings consistent with acute massive ingestion of phenytoin was noted. This case report and a review of cases reported in the English literature of acute single anticonvulsant ingestion further delineate the clinical presentation of acute phenytoin overdose.
Mellick
L B
LB
Emergency Medicine Service, Tripler Army Medical Center, HI.
Morgan
J A
JA
Mellick
G A
GA
D000293:Adolescent; D002606:Charcoal / Q000627:therapeutic use; D003975:Diazepam / Q000627:therapeutic use; D004630:Emergencies; D005751:Gastric Lavage; D006801:Humans; D008297:Male; D010672:Phenytoin / Q000506:poisoning*; D013406:Suicide, Attempted
D002606:Charcoal; D010672:Phenytoin; D003975:Diazepam