Recurrent carbon monoxide poisoning from cigarette smoking.
Carbon monoxide intoxication remains a major cause of morbidity and mortality in the United States with an estimate of 50,000 cases annually in emergency departments nationwide (Weaver, N Engl J Med. 2009;360:1217-25). Sources of carbon monoxide most often include car exhaust, malfunctioning heating systems and inhaled smoke. It has been well established that there is a dose-dependent increase in carboxyhemoglobin (COHb) concentration with tobacco use. It is generally accepted that heavy smokers have COHb levels <10% to 15% (Ernst and Zibrak, N Engl J Med. 1998;339:1603-8). The authors report a 48-year-old woman with significant tobacco abuse who presented with COHb levels as high as 24.2% in the face of tobacco use.
Sen
Soumitra
S
Department of Internal Medicine, Riverside Methodist Hospital, Columbus, Ohio 43214, USA. Soumitrasen.1983@gmail.com
Peltz
Carrie
C
Beard
Jennifer
J
Zeno
Brian
B
D002248:Carbon Monoxide / Q000097:blood; D002249:Carbon Monoxide Poisoning / Q000097:blood / Q000209:etiology* / Q000628:therapy; D002263:Carboxyhemoglobin / Q000378:metabolism; D005260:Female; D006801:Humans; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation
D002248:Carbon Monoxide; D002263:Carboxyhemoglobin