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4th Pediatric Infectious Diseases Conference

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Rakesh Kumar, Binay Ranjan, Manjul Vijay Department of Pediatrics, Katihar medical college, Katiha...

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Drug

Treatment Details

Thallium

Thallium sulphate and thallium acetate are important salts` which are odowebsiteess, tasteless and water-soluble. They are used in the dye and glass industries and as rodenticides and insecticides.

Fatal dose : one g.

Fatal Period : 24 to 36 hours.

Clinical picture : They occur after one to twelve days after a therapeutic dose due to overdose or idiosyncrasy. In mild cases` joint pains in the legs and feet, loss of appetite, stomatitis, and drowsiness occur, which pass off in a few days. In severe cases` there is colic, vomiting, pain in the muscles, joints and nerves, lethargy, motor and sensory neuropathies, convulsions, psychosis, optic neuritis, loss of hair, tremors, delirium and coma. There may be cardiac manifestations. Maculo-papular skin eruption having butterfly distribution on face is characteristic. There may be Mees lines on the nails. Death occurs due to respiratory failure due to paralysis of the respiratory muscles. After recovery, the patient may suffer from peripheral neuritis resembling Guillain Barre polyneuritis. Death appears to be natural.

Chronic Poisoning-
Thallium triad is characterised by alopecia, skin rashes, painful peripheral neuropathy and mental confusion with lethargy.

Treatment : 1} Stomach wash with 1 percent potassium iodide or Prussian blue
2} Activated charcoal
3} Prussian blue {potassium ferric cyanoferrate} 250 mg, kg, day orally in two divided doses
4} Haemodialysis along with haemoperfusion
5} Forced diuresis

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Should teicoplannin, colistin be used in case of neonatal sepsis where culture does not reveal any organism_?

No, it should be used only after drug sensitivity report

Yes, under guidance of an infectious disease expert

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