Citation

Petkovska L, Chibishev A, Stevcevska A, Smokovski I, Petkovski D, Antova E. Open Access Maced. J. Med. Sci 2017; 5(2): 231-235.

Affiliation

University Clinic of Cardiology, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia.

Copyright

(Copyright © 2017, Ss Cyril and Methodius University of Skopje)

DOI

10.3889/oamjms.2017.046

PMID

28507634

PMCID

PMC5420780

Abstract

BACKGROUND: Use and abuse of cocaine are associated with numerous adverse effects, independent of the route of administration. More severe conditions of poisoning, however, are observed after cocaine intravenous administration.

AIM: We present a case of severe poisoning after violent intravenous injection of cocaine, but with a good outcome. CASE PRESENTATION: Cocaine was intravenously (i.v.) administered in 16-years old female patient as a homicide attempt. Shortly after that, patient experienced series of generalised tonic-clonic seizures, was highly febrile (40°C), somnolent, agitated, presenting with tachycardia, tachypnea and with increased blood pressure 150/90 mmHg. Neurologic status, lumbar puncture and computerised tomography (CT) of the brain were without remarks. Electroencephalogram (EEG) was characterised with signs of diffuse encephalopathy, and acid-base analyses resulted in metabolic acidosis. Urine screening revealed the presence of cocaine and benzodiazepines. The patient presented with signs of the hepatic lesion, acute renal insufficiency (ARI), and increased D-dimers resulting from activated fibrinolysis. The patient was discharged in stable general condition after being hospitalised for 23 days.

CONCLUSION: Intravenous abuse of cocaine results in overdose and serous multi-system complications requiring multidisciplinary diagnostic and intensive therapeutic approach.

Language: en

Keywords

acute renal insufficiency; cocaine toxicity; hepatotoxicity; hyperthermia; intravenous application; seizures