Carboxyhemoglobin levels in children with nonspecific flu-like symptoms

Abstract

Although carbon monoxide intoxication is thought to account for approximately half of all deaths caused by poisons] the incidence of sublethal toxicity has not been well investigated in a pediatric population. The manifestations of CO poisoning may be severe or subtle. 24 Commo nly, signs and symptoms are gradual and simulate other illnesses.? ,3.5 Flu-like symptoms such as headache, dizziness, weakness, nausea, vomiting, and drowsiness are frequent? The purpose of our study was to determine the possibility of carbon monoxide poisoning as a cause of nonspecific flu-like symptoms in children who had no recognized exposure. METHODS Children younger than 18 years of age, consecutively seen in The Children's Hospital of Philadelphia Emergency Department for evaluation of flu-like symptoms (headache, dizziness, weakness, nausea, vomiting, altered mental status), were eligible for entry into the study. Excluded were patients with symptoms specifically suggestive of a viral illness, including fever >38.9 ~ C, watery stools, viral exanthem or enanthem, or with a history of smoke inhalation. Enrollees were also required to have one or more exPosure criteria, including the occurrence of symptoms while (1) a motor vehicle passenger; (2) a resident of a home with combustible fuel heat, including kerosene heaters, wood stoves, fireplaces, natural gas appliances, Sterno units, or central heating systems older than 10 years; or (3) exposed to chemical fumes such as those generated by paint strippers.