12th March 2024

Salicylate poisoning

Symptoms can include diaphoresis, fever, tinnitus, deafness and vasodilation. In severe toxicity, mixed respiratory/metabolic acidosis and cerebral/ pulmonary oedema may occur. Clinical toxicity is not closely correlated to serum concentration. Fluid therapy and electrolyte balance are crucial to the management of these patients. Multi-dose treatment with activated charcoal and urine alkalinisation using IV sodium bicarbonate can also be effective. Regardless of symptoms, haemodialysis should be considered over the serum concentration of 700 mg/L. Levels of over 900 mg/L mean urgent haemodialysis is definitively indicated. Quinine toxicity presents similarly to salicylate poisoning, with tinnitus, impaired hearing and blurred vision. Blindness can also occur with the onset often being delayed.