October 2014 Critical Care Case of the Month: A Skin Rash in the ICU

Thursday, October 2, 2014 at 8:00AM
Rick Robbins, M.D. in Staphylococcal infection, TSST-1, erythroderma, ethylene glycol, fomezipole, poisoning, sinusitis, skin desquamation, toxic shock syndrome, treatment

Robert A. Raschke, MD

Banner Good Samaritan Medical Center

Phoenix, AZ

 

History of Present Illness

A 28 year old man was admitted to an outside hospital with an ethylene glycol overdose in an apparent suicide attempt. At that time the patient was delirious and vomiting. He had a severe metabolic acidosis and a creatinine of 2.1 mg/dL. He was intubated, a nasogastric tube was placed, and he was transferred to the toxicology service.

PMH, FH, SH

There was no significant past medical history. Family history was noncontributory. He was a nonsmoker who recently had a fight with his girlfriend prompting the suicide attempt.

Physical Examination

Vital signs were stable and he was sedated and nasally intubated receiving mechanical ventilation. There were no other significant findings on physical examination

Which of the following can be used for ethylene glycol poisoning? (Click on the correct answer to proceed to the next of 5 panels)

1. Ethanol
2. Fomezipole
3. Hemodialysis
4. Pyridoxine
5. All of the above

Reference as: Raschke RA. October 2014 critical care case of the month: a skin rash in the ICU. Southwest J Crit Care Med. 2014;9(4):208-13. doi: http://dx.doi.org/10.13175/swjpcc110-14 PDF

Article originally appeared on Southwest Journal of Pulmonary, Critical Care and Sleep (https://www.swjpcc.com/).