salicylates and Laryngeal-Edema

Oil of Wintergreen (methyl salicylate) is a common ingredient for liniments, ointments and essential oils used in self-treatment of musculoskeletal pain. Its pleasant smell also encourages its use to flavour confectionery. The toxic potential of this preparation is not always fully appreciated by the general public and physicians. To appreciate the danger of this oil it can be compared to aspirin tablets (325 mg dose): one teaspoon (5 ml) of Oil of Wintergreen is equivalent to approximately 7000 mg of salicylate or 21.7 adult aspirin tablets. Ingestion of as little as 4 ml in a child can be fatal. Prevention of accidental ingestion of methyl salicylate containing products can be achieved by keeping the products out of reach of children, using child resistant bottles, restricting the size of the openings of the bottles, appropriate labeling on products and reducing the salicylate content. Immediate action should be taken to treat a patient with accidental poisoning and hospitalisation is needed for monitoring and treatment. The danger of this product should be fully appreciated by both physicians and the general public. We present a case of Oil of Wintergreen poisoning with development of laryngeal oedema as a complication, general information and management issues will also be discussed.

Topics: Female; Humans; Infant; Laryngeal Edema; Poisoning; Salicylates

Idiosyncrasy to salicylic acid and related substances is well known, the most common symptoms being asthma, rhinorrhea and urticaria. We here describe two cases whose only symptoms were hoarseness and in which inspection revealed laryngeal edema when the patients ingested any of these substances. In cases of chronic recurring hoarseness, a history should be taken with respect to such hypersensitivity and suspect cases should be challenged, since a strict diet may improve the symptoms.

Topics: Adult; Aspirin; Drug Hypersensitivity; Female; Hoarseness; Humans; Laryngeal Edema; Male; Salicylates