Persistent effects after camphor ingestion: a case report and literature review.

BACKGROUND

Camphor is a well-known toxin responsible for thousands of poisonings per year. It can be found in many over-the-counter remedies and illegally imported substances. The toxidrome manifests within minutes and includes gastrointestinal, neurologic, pulmonary, and cardiac effects. Severe ingestions may progress to seizures, apnea, and coma. Most individuals are no longer symptomatic outside the 24-48 h window, but physiologic derangement may persist for far longer in some instances.

METHODS

This is a case report of a 25-year-old Guatemalan woman with no past medical history who ingested a cube of camphor for a facial rash. She presented to the Emergency Department with persistent delirium and headache 6 days after ingestion. She had a protracted recovery but returned to her baseline state of health 19 days after ingestion. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Persistent toxic effects of camphor are not well described, and most sources state that the toxidrome resolves in 24-48 h. Given the frequency of camphor poisoning, it is crucial to increase public awareness of camphor toxicity, to understand the biological mechanism of the effects, and to develop more targeted treatments. From the emergency physician's perspective, it is important to realize that toxic effects of camphor poisoning may persist far beyond the 24-48 h window and require attention.