Cyanide intoxication with encephalitis clinic: a case report

Cyanide intoxication is one of the most dangerous poisonings and may occur by oral, respiratuary and dermal routes. Central nervous system is the most susceptible region to acute cyanide intoxication. A 3.5-years-old-girl was brought to our pediatric emergency polyclinic with complaints of fever, dullness and convulsion. On physical examination, lethargy and agitation, increased deep tendon reflexes and bilateral extensor plantar response were determined. On brain magnetic resonance imaging, increased signal intensity and decreased diffusion in bilateral basal ganglia on T2-fluid-attenuated inversion-recovery sequences were determined. The patient diagnosed as intoxication or encephalitis was taken to intensive care unit. Gastric lavage was performed and activated charcoal and acyclovir were given. After these managements, it was learnt that she had eaten a lot of apricot, plum and seed of apricot before the complaints. Therefore, she was diagnosed as cyanide intoxication and hydroxycobalamin treatment was given for five days. Our aim is to emphasize that in patients who were brought with symptoms and signs of encephalitis, intoxications also should be thought in differential diagnosis; therefore, we want to underline once again that taking detailed anamnesis is very important.