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Acute Cyanide Intoxication Due To Apricot Seed Ingestion

Published:November 16, 2012DOI:https://doi.org/10.1016/j.jemermed.2012.05.041
      A previously healthy 3-year-old girl was admitted to our Emergency Department (ED) in an unconscious state. The pediatric version of the Glasgow Coma Scale score was 6 on her first assessment. Her history revealed that she had eaten 8–12 pieces of apricot seeds and about an hour later had vomited 7 times; then she developed lethargy and loss of consciousness. Her history revealed that she chewed the apricot seeds before swallowing. Her medical and family history otherwise were not significant.
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      Linked Article

      • Acute Cyanide Intoxication Due to Apricot Seeds: Is “Evidence” Countable?
        Journal of Emergency MedicineVol. 48Issue 1
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          We read the letter to the editor by Akıl et al. with great interest (1). However, we have serious doubts about assigning cyanide as the poisoning agent. This letter also has raised some concerns about the diagnostic, clinical, and therapeutic aspects of the case reported. The child did not exhibit the classic symptoms of cyanide poisoning, for example, high anion gap metabolic acidosis. In addition, the authors did not mention the child's lactate level, which can be used as a surrogate marker for cyanide intoxication when the blood cyanide level cannot be measured due to technical limitations (2).
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