Latest Articles and News - Jun 23, 2025

[Health risks linked to water and food. Food poisoning].

https://pubmed.ncbi.nlm.nih.gov/40546212/

Caffeine Overdose Resulting in Seizure-like Activity and Rhabdomyolysis in a Child: A Case Report.

Caffeine is a commonly used medication throughout pediatrics for its medicinal effects and recreation. While multiple reports have shown concern for overdoses in adolescents and adults, there is little reported on caffeine's effects on younger children. We present the case of a 4-year-old female with developmental delay with associated seizures, who presented with unexplained tachycardia, and concern for increased seizure activity. After EEG showed no evidence of epileptiform changes, further investigation showed rhabdomyolysis, hypokalemia, tachycardia and ultimately elevated caffeine levels. This resulted in a diagnosis of factitious disorder by proxy. This is a rare case of caffeine overdose in a child resulting in rhabdomyolysis. While other stimulants are commonly considered in patients with such symptoms, and are included in standard drug screens, caffeine should also be evaluated as a cause of unexplained hyperactive behaviors, particularly in the non-verbal patient.

https://pubmed.ncbi.nlm.nih.gov/40545403/

Coma as the Sole Initial Manifestation of Levothyroxine Intoxication: A Case Report.

Levothyroxine overdose rarely causes severe symptoms in adults. We present an unusual case of isolated coma after massive levothyroxine ingestion. A 33-year-old woman presented to the Emergency Department comatose (Glasgow Coma Scale score 3/15) but hemodynamically stable. Computed tomography of the brain was normal. History revealed ingestion of 10.5 mg levothyroxine 2 h prior in a suicide attempt. Gastric lavage and activated charcoal were administered. The patient was intubated and admitted to the intensive care unit (ICU). Treatment included cholestyramine for enhanced thyroxine elimination. Thyroid function tests showed elevated free T4 and T3 with initially normal, but later suppressed, thyroid-stimulating hormone. The patient developed fever at 20 h, attributed to aspiration pneumonia rather than thyroid storm. She regained consciousness and was extubated at 28 h. Total ICU stay was 72 h. She was discharged after 10 days, with no complications. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: This case is notable for isolated coma without typical thyrotoxicosis symptoms, in spite of massive levothyroxine ingestion. Although altered mental status has been reported in levothyroxine overdose, coma as the sole presenting symptom is extremely rare. Emergency physicians should consider levothyroxine toxicity in cases of unexplained coma, even without other thyrotoxicosis signs. Prompt supportive care and gastrointestinal decontamination can lead to favorable outcomes in severe overdose.

https://pubmed.ncbi.nlm.nih.gov/40545400/