Presentation
We present a case of intentional caffeine poisoning in a 5-week-old infant and review treatment. This infant later suffered fatal physical abuse. [pediatrics.aappublications.org]
Case presentation A 32-year-old woman with no significant medical and family history presented to the local emergency department (ED) referring malaise, anxiety, dizziness and nausea. [casereports.bmj.com]
Indeed, many patients present at ages or with histories incompatible with “accidental” ingestion, others may even present with histories of recurrent illnesses suggesting previous undiagnosed poisonings. [ncbi.nlm.nih.gov]
Entire Body System
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Physician
The emergency medicine physician is responsible for stabilizing the patient and coordinating the patient's care while in the emergency department. [ncbi.nlm.nih.gov]
After stabilisation, the patient informed the ED’s physician that when she was preparing the preworkout supplement, used the same dosage of the proteic supplement for anhydrous caffeine, instead of 1 dose of 300 mg (6 mg/kg) of anhydrous caffeine, the [casereports.bmj.com]
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Collapse
In cases of caffeine poisoning, death may result from cardiovascular and respiratory collapse. Also called caffeinism [kafē′nizəm], caffeism [kaf′ē·izm]. See also xanthine derivative. [medical-dictionary.thefreedictionary.com]
Treatment of cardiovascular collapse from caffeine overdose with lidocaine, phenylephrine, and hemodialysis. Am J Emerg Med. 2009 Feb; 27 (2):253.e3-6. [ PubMed : 19371553 ] 22. Holstege A, Kurz M, Weinbeck M, Gerok W. [ncbi.nlm.nih.gov]
Respiratoric
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Aspiration
Those who do not seek treatment or the treatment is delayed may develop seizures, arrhythmias or even aspirate the vomitus. Over the past decade, less than 3 dozen deaths have been reported. [ncbi.nlm.nih.gov]
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Tachypnea
On arrival in a regional newborn center, they exhibited one or more of the following symptoms: tachypnea, fine tremor of the extremities, opisthotonus, tonic-clonic movements, and nonpurposeful jaw and lip movements. [jamanetwork.com]
Gastrointestinal
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Nausea
Symptoms include restlessness, anxiety, general depression, tachycardia, arrhythmias (premature atrial contractions), tremors, nausea, diuresis, and insomnia. [medical-dictionary.thefreedictionary.com]
Case presentation A 32-year-old woman with no significant medical and family history presented to the local emergency department (ED) referring malaise, anxiety, dizziness and nausea. [casereports.bmj.com]
Urogenital
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Cesarean Section
He was born at 37 weeks' gestation by second cesarean section to a 22-year-old gravida 3, para 2 mother. The pregnancy was significant for gestational diabetes mellitus requiring insulin. [pediatrics.aappublications.org]
Neurologic
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Intracranial Hemorrhage
hemorrhage Iron toxicity Monoamine oxidase inhibitor toxicity Multifocal atrial tachycardia Polysubstance overdose Septic shock Status epilepticus Theophylline toxicity Thyrotoxicosis Ventricular fibrillation Ventricular tachycardia Prognosis There are [ncbi.nlm.nih.gov]
Workup
Serum
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Hyponatremia
Caffeine toxicity can result in hypokalemia, hypocalcemia, hyponatremia, and hyperglycemia. It is also important to obtain serum myoglobin and creatine kinase levels to monitor for rhabdomyolysis. [ncbi.nlm.nih.gov]
Rhythm
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Premature Atrial Contractions
Symptoms include restlessness, anxiety, general depression, tachycardia, arrhythmias (premature atrial contractions), tremors, nausea, diuresis, and insomnia. [medical-dictionary.thefreedictionary.com]
T Wave
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T Wave Inversion
An electrocardiogram may demonstrate tachycardia, ST-segment depressions, or T-wave inversions. [ncbi.nlm.nih.gov]
Treatment
Mortality is very rare for patients who seek treatment. Those who do not seek treatment or the treatment is delayed may develop seizures, arrhythmias or even aspirate the vomitus. Over the past decade, less than 3 dozen deaths have been reported. [ncbi.nlm.nih.gov]
We present a case of intentional caffeine poisoning in a 5-week-old infant and review treatment. This infant later suffered fatal physical abuse. [pediatrics.aappublications.org]
A severe overdose, marked by difficulty breathing, irregular or rapid heartbeat, chest pains, or vomiting requires prompt medical treatment. [wikihow.com]
The supportive treatment, including intravenous fluids, propranolol, potassium and phosphorus supplementations, stabilised the patient’s clinical status. [casereports.bmj.com]
Prognosis
Serum caffeine levels can guide prognosis and therapy. [ncbi.nlm.nih.gov]
Etiology
[…] overuse or severe toxicity with an intentional overdose. [2] Lethal doses of caffeine have been reported at blood concentrations of 80 to 100 micrograms/ml which can be reached with ingestion of approximately 10 grams or greater. [3] [4] [5] [6] [7] Etiology [ncbi.nlm.nih.gov]
Epidemiology
Some examples include health food products, diet aids decongestants, bronchodilators, or stay-awake pills. [13] Epidemiology In 2016 there were 3702 caffeine related exposures reported to Poison Control Centers in the United States, with an equal ratio [ncbi.nlm.nih.gov]
Pathophysiology
There have been several caffeine-related deaths reported in case studies. [12] Pathophysiology Due to caffeine’s ability to affect a variety of different receptors, the side effects of caffeine overdose can be profound. [ncbi.nlm.nih.gov]
Prevention
Seeking Outside Help Treating Mild Symptoms At Home Preventing a Reoccurrence Ask a Question Related Articles References Caffeine is a stimulant that keeps you awake and alert. [wikihow.com]
Authors also indicated the blood levels of caffeine and highlighted that even high blood concentration of caffeine in infants can be successfully treated, thus preventing the death of the patient [ 23 ]. [ncbi.nlm.nih.gov]
Not only should non-invasive monitoring, like continuous cardiac monitoring, and fingerstick glucose level be rapidly obtained, but also intravenous access must be established. 9 11 12 To prevent systemic effects of the caffeine metabolism, activated [casereports.bmj.com]