August 30

Yesterday in class a point was made that to properly assess a poisoned patient no detail can be overlooked.  From vital signs to history and physical exam, all are important.  Yellow phosphorus is a case in point.  Yellow phosphorus is one of the ingredients used to make fireworks.  As noted in, "Ates M et al. Living donor liver transplantation for acute liver failure in pediatric patients caused by the ingestion of fireworks containing yellow phosphorus. 2011 Liver Transplantation 17:1286-1291", blood levels are not helpful and there are no diagnostic tests to run.  The authors of this paper point out that,  “if the history is unclear, a garlicky odor and luminescence of vomitus or stool may be helpful. Faint fumes emanating from the stool are called smoking stool syndrome”.  You have got to love toxicology!  

Thank you to the American Academy of Clinical Toxicology, Tox Question of the Day.