digoxin and Respiratory-Tract-Infections

An 87-year-old male, prescribed digoxin and furosemide for congestive heart failure and Alzheimer disease, had dehydration and anemia due to poor food intake and hemorrhagic cystitis. Repeated vomiting due to an upper respiratory infection caused disturbance of consciousness and hypotension. The patient was admitted to hospital and diagnosed with digoxin intoxication and hypernatremia. The serum sodium (Na(+)) level was corrected, but the patient died 4 days after admission following uncontrollable seizure. A histologic examination after an autopsy revealed characteristic findings of central pontine myelinolysis (CPM). This is the first autopsy report on CPM triggered by vomiting in association with digoxin administration.

Topics: Aged, 80 and over; Brain; Cardiotonic Agents; Digoxin; Fatal Outcome; Forensic Pathology; Humans; Hypernatremia; Hypokalemia; Male; Myelinolysis, Central Pontine; Respiratory Tract Infections; Seizures; Staining and Labeling; Vomiting

Topics: Acute Kidney Injury; Aged; Ankle Injuries; Anti-Arrhythmia Agents; Antidotes; Digoxin; Female; Fractures, Bone; Humans; Immunoglobulin Fab Fragments; Respiratory Tract Infections; Syncope

Topics: Acute Disease; Child, Preschool; Digoxin; Diuretics; Heart Diseases; Humans; Infant; Infant, Newborn; Respiratory Tract Infections; Strophanthins

Topics: Anemia; Anti-Bacterial Agents; Cardiomyopathies; Diet, Sodium-Restricted; Digoxin; Diuretics; Heart Defects, Congenital; Heart Failure; Humans; Infant; Infant, Newborn; Myocarditis; Palliative Care; Respiratory Tract Infections; Rest; Tachycardia, Paroxysmal

Topics: Blood Pressure; Child; Digitalis Glycosides; Digitoxin; Digoxin; Diuretics; Drug Therapy; Fluid Therapy; Heart Auscultation; Heart Defects, Congenital; Heart Failure; Humans; Infant; Lanatosides; Liver Circulation; Morphine; Oxygen Inhalation Therapy; Parenteral Nutrition; Posture; Respiratory Tract Infections; Rest; Shock; Sodium; Water-Electrolyte Balance