Journal de toxicologie clinique
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Abstrait

Intoxication by Massive Ingestion of Poppers: A Case Report

Alexandre Behouche, Claire Chapuis, Pierre Albaladejo and Michel Durand

Background: Poppers are commonly inhaled for their recreative properties. Oral intakes are scarce, and clinical presentation and management of massive ingestions are poorly described in literature. We report a haemodynamic failure due to massive oral intake of poppers, and its evolution.

Case presentation: A 47 years old healthy man drank by mistake about 5 mL of poppers. Respiratory and haemodynamic failures grew quickly; requiring admission in intensive care unit, oxygen therapy, volume expansion and norepinephrine up to 2 mg/h. Methaemoglobinemia reached 32% and required methylene blue infusion, falling to less than 5% after 6 hours. Respiratory failure gradually improved, as well than hypotension allowing norepinephrine withdrawal in the first 24 hours. Patient was then promptly discharged at home without any aftereffect.

Conclusions: This case mainly brings to light the strong hemodynamic effect of a massive oral intake of poppers and its fast kinetics, poorly described in literature. Physiopathological mechanisms involved and pharmacological properties of aryl-nitrites are fully compatible with our clinical observation.