RT Journal Article
SR Electronic
T1 Lessons of the month 3: Intravenous poppers abuse: case report, management and possible complications
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 221
OP 223
DO 10.7861/clinmed.2019-0469
VO 20
IS 2
A1 Alexander Reisinger
A1 Susanne Vogt
A1 Anna Essl
A1 Ines Rauch
A1 Florian Bangerl
A1 Philipp Eller
A1 Gerald Hackl
YR 2020
UL http://www.rcpjournals.org/content/20/2/221.abstract
AB Background Poppers are nitrite-containing liquids, which are inhaled for their aphrodisiac and hallucinogenic effects. Despite some cases of severe poisonings, poppers are often perceived as harmless by consumers. Inhalation and ingestion of poppers are well known, but, according to our literature review, intravenous abuse has not been reported before.Case presentation A 34-year-old man injected poppers intravenously for recreational purposes. He then suffered from dyspnoea and general discomfort. Upon arrival of emergency medical services, the patient was dyspnoeic with blue-grey skin colour and oxygen saturation was 82% on ambient air. Non-invasive ventilation was necessary, and he was transferred to the intensive care unit. Toluidine blue was administered because of a methaemoglobinaemia of 40% and methaemoglobin levels dropped to 0.4%. He was discharged home after a 24-hour observation. We additionally analysed the contents of the poppers bottle: isopropyl nitrite, isopropanol and acetone were detected. Possible complications and the treatment regarding intravenous administration of poppers are discussed.Conclusion We present the first published case of intravenous poppers abuse. Our patient suffered from methaemoglobinaemia and was rapidly discharged after treatment with toluidine blue. No specific treatment regarding the contents of the poppers bottle, apart from isopropyl nitrite, was necessary.