Case history
Case history
An 80-year-old man with a 24-hour history of progressive headache, vomiting, and dizziness is brought to the emergency department by his wife, who has also been having similar symptoms. Before presentation to the emergency department she found him to be confused. On examination, the man is awake, appears confused, and has difficulty walking due to generalised weakness.
Other presentations
Other less common clinical presentations of carbon monoxide poisoning include rhabdomyolysis, acute kidney injury from muscle damage, skin bullae, and non-cardiogenic pulmonary oedema. Children can present with non-specific symptoms mimicking viral illness such as nausea and vomiting, but fever and other symptoms of infection are usually absent. Delayed effects can be seen up to 6 weeks after exposure and include confusion, ataxia, hallucinations, and motor and gait disturbances. Long-term exposure to low levels of carbon monoxide can cause anorexia, personality disorders, acceleration of atherosclerosis, and polycythaemia and cardiomegaly due to chronic hypoxia.[5] Even mild symptoms in a pregnant woman can have devastating effects on the unborn child, such as fetal demise or congenital malformations. Fetal haemoglobin has a much greater affinity for carbon monoxide than adult haemoglobin.
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