Crack-ing the case: a patient with persistent delirium due to body packing with cocaine.
A 36-year-old male presented acutely with encephalopathy, following his return to Ireland from a visit to West Africa. Clinical findings included confusion, agitation and tonic-clonic seizures. Difficulties in weaning sedation prompted repeat urine toxicology screening at day 8, which was positive for cocaine. Work-up for a source of continued cocaine exposure led to the discovery of cocaine-containing packages in the gastrointestinal tract. An index of suspicion should be maintained in patients presenting with drug toxicity following cross-border travel.
Department of General Internal Medicine, Mater Misericordiae University Hospital, Eccles St, Dublin 7. dmmnic@umail.ucc.ie
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Ní Chróinín
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Gaine
D000328:Adult; D003042:Cocaine / Q000506:poisoning*; D003106:Colon; D003693:Delirium / Q000209:etiology*; D005547:Foreign Bodies / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D011859:Radiography; D012640:Seizures / Q000209:etiology*; D014195:Travel
D003042:Cocaine