Oxycodone
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Various toxcities secondary to intoxication: case report A 3-year-old boy developed toxic leukoencephalopathy, multi-organ injury and cerebellitis secondary to intoxication with oxycodone. The boy ingested oxycodone [indication and dosage not stated]. He was found to be unresponsive when his mother tried to awaken him in the morning. He was hospitalised where investigations revealed Glasgow coma score (GCS) of 8 and concurrent pressure ulcers. His pupils were non-reactive. Laboratory investigations were suggestive of disseminated intravascular coagulation, multi-organ injury and a mixed respiratory and metabolic acidosis. Subsequent CT scan displayed diffuse cerebellar oedema with impending cerebellar herniation. On the same day, MRI investigation revealed leukoencephalopathy, cerebellitis, upward pontine herniation and herniation of the cerebellar tonsils. The boy was immediately treated with decompressive craniotomy and laminectomy. Extended serum drug screen was found to be positive for oxycodone. Mass spectroscopy also displayed positive results for oxycodone. He remained comatose for several months. Upon follow-up, four months later, slow improvement of neurologic function was observed. He was able to move all extremities. However, he displayed significant spasticity and impairment. He also experienced oral aversion requiring a G-tube for nutrition. He was able to speak in short sentences. He also experienced substantial vision loss. He was diagnosed with toxic leukoencephalopathy, multiorgan injury and cerebellitis secondary to oxycodone intoxication [duration of treatment to reaction onset not stated; not all outcomes stated]. Author comment: "Here we describe a 3-year-old male who presented with cerebellitis, leukoencephalopathy, and multi-organ dysfunction secondary to oxycodone ingestion." "Practitioners should recall leukoencephalopathy as a presentation of opioid intoxication as the US struggles to combat the growing opioid epidemic and consider early neurosurgical consultation." Wheaton T, et al. Opioid-induced toxic leukoencephalopathy and multiorgan dysfunction in a pediatric patient. Critical Care Medicine 47 (Suppl.): 382 abstr. 806, No. 1, Jan 2019. Available from: URL: https://cdn.journals.lww.com/ ccmjournal/ Citation/2019/01001/806__OPIOID_INDUCED_TOXIC_LEUKOENCEPHALOPATHY_AND.766.aspx 803432205 [abstract] - USA
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Reactions 9 Nov 2019 No. 1778
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