Iodoform intoxication; a case report of prolonged consciousness disturbance in a patient with a high plasma iodine level.
This report describes a case in which a consciousness disturbance was associated with a high plasma iodine level and which improved after the removal of iodoform gauze that had been applied to infected wounds. A 71-year-old male with poorly controlled diabetes underwent a laminectomy for an epidural abscess. On the 6th and 8th postoperative days, he underwent debridement for fasciitis in the both arms and iodoform gauze was applied to the wounds (both arms and lumbar region) at the end of the first debridement and then changed every day. His consciousness then gradually deteriorated after the debridement. His plasma iodine level was measured and was shown to be remarkably high (6,280 microg/dl) 19 days after the laminectomy (13 days after the beginning of iodoform application). His consciousness recovered gradually with a concomitant decrease in the plasma iodine level. Three months after the removal of the iodoform he became almost alert. Caution should be exercised in using iodoform gauze because of the possibility that it could affect consciousness.
Araki
Kazukuni
K
Department of Anesthesiology and Critical Care Medicine, Saga Medical School.
Hirakawa
Naomi
N
Kosugi
Toshifumi
T
Higashimoto
Ikuyo
I
Kakiuchi
Yoshinobu
Y
Nakashima
Mikio
M
D000368:Aged; D003244:Consciousness Disorders / Q000139:chemically induced*; D006801:Humans; D006847:Hydrocarbons, Iodinated / Q000506:poisoning*; D007455:Iodine / Q000097:blood*; D008297:Male; D011183:Postoperative Complications; D015503:Surgical Sponges / Q000009:adverse effects
D006847:Hydrocarbons, Iodinated; D007455:Iodine; C010473:iodoform