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{
    "pk": 1079,
    "title": "A Chemist with a Strange Etiology of Rhabdomyolysis: A Case Report of a Rare Toxicological Emergency",
    "subtitle": null,
    "abstract": "Introduction: \nChloroform, a halogenated hydrocarbon, causes central nervous depression, hepatotoxicity, nephrotoxicity, and rhabdomyolysis. Historically, chloroform had been used as a general anaesthetic and today is still used in chemical industries. Lack of proper personal protective equipment and adequate knowledge about its toxic effects can lead to serious harm.\nCase report:\n A 33-year-old gentleman presented to the emergency department (ED) with altered mental status. Given his depressed mental status, the decision was made to intubate shortly after arrival for airway protection. Further history raised suspicion of occupational chloroform exposure. Brown-colored urine further strengthened suspicion of chloroform poisoning with resultant rhabdomyolysis. Forced alkaline diuresis and N-acetylcysteine were started in the ED. His mental status and respiratory efforts improved on hospital day two, and he was ultimately extubated. Creatine phosphokinase and myoglobin levels were initially high but gradually came down by hospital day six. On hospital day 10, the patient was deemed stable and safely discharged.\nConclusion:\n A patient with chloroform inhalation who suffered resultant rhabdomyolysis and hepatotoxicity was successfully treated with early initiation of forced alkaline diuresis, N-acetylysteine, and hemodialysis.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "chloroform"
        },
        {
            "word": "poisoning"
        },
        {
            "word": "rhabdomyolysis"
        },
        {
            "word": "N-acetylcysteine"
        }
    ],
    "section": "Case Reports",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/8kn0j1x3",
    "frozenauthors": [
        {
            "first_name": "Rajadurai",
            "middle_name": "",
            "last_name": "Meenakshisundaram",
            "name_suffix": "",
            "institution": "Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India",
            "department": "None"
        },
        {
            "first_name": "Joshua",
            "middle_name": "Vijay",
            "last_name": "Joseph",
            "name_suffix": "",
            "institution": "Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India",
            "department": "None"
        },
        {
            "first_name": "Prabakaran",
            "middle_name": "",
            "last_name": "Perumal",
            "name_suffix": "",
            "institution": "Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India",
            "department": "None"
        },
        {
            "first_name": "Akmal",
            "middle_name": "",
            "last_name": "Areeb",
            "name_suffix": "",
            "institution": "Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India",
            "department": "None"
        },
        {
            "first_name": "Prathap",
            "middle_name": "",
            "last_name": "Pancheti",
            "name_suffix": "",
            "institution": "Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India",
            "department": "None"
        },
        {
            "first_name": "Dinesh",
            "middle_name": "Kannan",
            "last_name": "Sampath",
            "name_suffix": "",
            "institution": "Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India",
            "department": "None"
        },
        {
            "first_name": "Esther",
            "middle_name": "Monica",
            "last_name": "Jared",
            "name_suffix": "",
            "institution": "Apollo KH Hospital, Department of Emergency Medicine and Critical Care, Melvisharam, Tamil Nadu, India",
            "department": "None"
        }
    ],
    "date_submitted": "2021-09-09T22:57:28Z",
    "date_accepted": "2021-09-09T22:57:28Z",
    "date_published": "2021-09-09T22:59:07Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "",
            "path": "https://journalpub.escholarship.org/uciem_cpcem/article/1079/galley/821/download/"
        }
    ]
}