Disulfiram ethanol reaction mimicking anaphylactic, cardiogenic, and septic shock.
Shock is a common reason for medical intensive care unit admission, with septic and cardiogenic accounting for most of the etiologies. However, the potential severity of adverse side effects of drugs indicates that any medication should be carefully scrutinized for potential pharmacokinetic and pharmacodynamic interactions that may result. We herein report the case of a life-threatening shock mimicking successively anaphylactic, cardiogenic, and septic shock, which was finally related to disulfiram ethanol reaction. Indeed, disulfiram ethanol reaction is known to provoke unpleasant symptoms through vasodilatation in various organs. However, extreme manifestations of vasodilatory shock may lead to circulatory failure and lactic acidosis. Because of large prevalence of alcoholism and disulfiram medication, emergency physicians and medical specialists should be aware of this life-threatening condition, with its misleading presentation.
Medical Intensive Care Unit, Cochin Hospital, Groupe Hospitalier Cochin Broca Hôtel-Dieu, Assistance Publique des Hôpitaux de Paris, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France.
Simon
S
Bourcier
Nicolas
N
Mongardon
Fabrice
F
Daviaud
Laurence
L
Moachon
Marc-Antoine
MA
Arnould
Franck
F
Perruche
Frédéric
F
Pène
Alain
A
Cariou
D000368:Aged; D000427:Alcohol Deterrents / Q000506:poisoning*; D000707:Anaphylaxis / Q000175:diagnosis; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D004221:Disulfiram / Q000506:poisoning*; D000431:Ethanol / Q000506:poisoning*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D012770:Shock, Cardiogenic / Q000175:diagnosis; D012772:Shock, Septic / Q000175:diagnosis
D000427:Alcohol Deterrents; D000431:Ethanol; D004221:Disulfiram