Abstract
We treated a case of metabolic acidosis and delirium induced by 4g of nalidixic acid ingestion. A 32-year-old previously healthy woman suffering from dyspnea was brought to our emergency treatment center delirious, screaming continuously, and hyperventilating. Arterial blood gas analysis revealed acidemia with metabolic acidosis and compensatory respiratory alkalosis. Intravenous administration of sodium bicarbonate, gastric lavage, and activated charcoal administration through a gastric tube restored her orientation after receiving sodium bicarbonate, which suggested acidemia affected her consciousness. She was lucid and had fully recovered 12 hours after drug ingestion. One hour after drug ingestion, serum nalidixic acid concentration was 155.16μg/ml, 68.80μglml 3 hours after, and 0.065μg/ml 14 hours after.
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