Page 100 - GTM-3-1

Global Translational Medicine Complication of carbon monoxide poisoning

injury types have been reported in the literature, such as Availability of data
erythema, vesicles, edema, abscesses, and ulcers, which are
found in approximately 30% of patients and develop mainly The data that support the findings of this case report are
in skin areas subjected to pressure. The most common skin openly available at https://doi.org/10.36922/gtm.1718
lesion is cherry-red erythema, which is often erroneously References
diagnosed as a burn. This type of injury is thought to
be caused by pressure skin necrosis and CO-mediated 1. Mattiuzzi C, Lippi G. Worldwide epidemiology of carbon
inhibition of tissue oxidative enzymes. 11 monoxide poisoning. Hum Exp Toxicol. 2020;39(4):387-392.
doi: 10.1177/0960327119891214
4. Conclusion
2. Ernst A, Zibrak JD. Carbon monoxide poisoning. N Engl J
CO poisoning is a prevalent issue, with a multitude of annual Med. 1998;339(22):1603-1608.
emergency department admissions. A limited number of doi: 10.1056/NEJM199811263392206
these patients may have cardiac injury as well as striated
muscle (rhabdomyolysis) and skin (cherry red erythema) 3. Ng PC, Long B, Koyfman A. Clinical chameleons: An
emergency medicine focused review of carbon monoxide
involvement. It is essential for emergency physicians to poisoning. Intern Emerg Med. 2018;13:223-229.
diagnose these complications in time, especially cardiac
complications, to prevent permanent myocardial damage. doi: 10.1007/s11739-018-1798-x
Given the increasing utility of point-of-care ultrasound by 4. Ahmad SA, Brito D, Khalid N, Ibrahim MA. Takotsubo
emergency physicians, the detection of this disease will be cardiomyopathy. In: Statpearls. Treasure Island (FL):
more feasible if they are aware of this important correlation StatPearls Publishing; 2023.
between CO poisoning and multiorgan damage. One must 5. Boyd B, Solh T. Takotsubo cardiomyopathy: Review of
further bear in mind that Takotsubo syndrome could broken heart syndrome. JAAPA. 2020;33(3):24-29.
share multiple etiologies, such as CO poisoning as well doi: 10.1097/01.JAA.0000654368.35241.fc
as coronary microvascular dysfunction, coronary artery
spasm, catecholamine-induced myocardial stunning, 6. Cha YS, Kim H, Hwang SO, et al. Incidence and patterns of
reperfusion injury following acute coronary syndrome, cardiomyopathy in carbon monoxide-poisoned patients with
myocardial injury. Clin Toxicol (Phila). 2016;54(6):481-487.
myocardial microinfarction, and abnormalities in cardiac
fatty acid metabolism. 12 doi: 10.3109/15563650.2016.1162310
7. Wittstein IS, Thiemann DR, Lima JA, et al. Neurohumoral
Acknowledgments features of myocardial stunning due to sudden emotional

None. stress. N Engl J Med. 2005;352(6):539-548.
doi: 10.1056/NEJMoa043046
Funding
8. Jang SW, Jeon JC, Choi WI. Risk factors associated with
None. complications of carbon monoxide poisoning. J Korean Soc
Clin Toxicol. 2009;7(1):10-18.
Conflict of interest
9. Kang SW, Kim YW, Kim YH. Analysis of nontraumatic
The authors declare that they have no competing interests. rhabdo myolysis during recent 2 years. Korean J Med.
2004;67:467-474.
Author contributions 10. Chung KJ, Chung YK, Yoo JH, Wang JS. Sciatic nerve
Conceptualization: Damiano Cardinale palsy complicating gluteal compartment syndrome due
Investigation: Damiano Cardinale, Edoardo Pennacchio to rhabdomyolysis: A case report. J Korean Orthop Assoc.
Writing – original draft: Damiano Cardinale, Marco Russo 2005;40:103-106.
Writing – review & editing: Damiano Cardinale, Marco 11. Myers RA, Snyder SK, Majerus TC. Cutaneous blisters
Russo and carbon monoxide poisoning. Ann Emerg Med.
1985;14(6):603-606.
Ethics approval and consent to participate doi: 10.1016/s0196-0644(85)80792-7
Patient gave consent to participate in the study 12. Komamura K, Fukui M, Iwasaku T, Hirotani S, Masuyama T.
Takotsubo cardiomyopathy: Pathophysiology, diagnosis and
Consent for publication treatment. World J Cardiol. 2014;6(7):602-609.
Patient gave consent to publish data. doi: 10.4330/wjc.v6.i7.602

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