Acute inhalation toxicity of T-2 mycotoxin in mice*1
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The aftereffects of home-induced emesis with ipecac syrup were determined by telephone interviews of callers to a poison center. During the 12-week study, the presence of any symptoms at follow-up in 146 patients was compared with findings in 99 callers to the poison center who did not receive ipecac. Within four hours after ipecac-induced emesis, 33.6% had no symptoms and 17.1% experienced protracted emesis. In the ipecac-treated group the incidences of one formed stool (4.1%) and lethargy during a typical sleeping time (42.5%) were not significantly different from the incidences in patients not receiving ipecac syrup. The incidences of diarrhea (13.0%) and atypical lethargy (11.6%) were higher (P less than .025 and P less than .05, respectively) after ipecac-induced emesis than in patients not receiving ipecac syrup. There was no significant statistical association between the propensity of the ingested toxin to produce diarrhea or lethargy and the occurrence of diarrhea or atypical lethargy. Because ipecac-induced emesis can produce diarrhea and lethargy, these side effects should be noted and differentiated from normal conditions when ipecac syrup is administered.
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The author's experience with lethargy in pediatric patients with intussusception was reviewed retrospectively over a 10-year period and proved to be a symptom elicited on admission in half of the patients. The results indicate that lethargy is an important symptom in patients with intussusception when occurring in association with vomiting, melena, or a palpable abdominal mass, or all three.
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Intro -- Clinical Cases in Avian and Exotic Animal Hematology and Cytology -- CONTENTS -- Preface -- Acronyms and Abbreviations -- Section 1: Mammalian Hematology Case Studies -- Case 1. A 6-year-old otter undergoing a routine physical examination -- Case 2. A 10-year-old ferret with lethargy and anorexia -- Case 3. A 6-year-old ferret with anorexia and lethargy -- Case 4. A 2-year-old ferret with weight loss and lethargy -- Case 5. A 3-year-old rabbit with anorexia -- Case 6. A 6-year-old hedgehog with anorexia and ataxia -- Case 7. A 7-year-old guinea pig with anorexia and decreased water intake -- Case 8. A 31/2-year-old ferret with lethargy and weight loss -- Section 2: Avian Hematology Case Studies -- Case 9. A 1-year-old parrot with an acute onset of severe illness -- Case 10. A 2-year-old chicken with lethargy, inappetence, and lack of egg laying -- Case 11. A 14-year-old macaw with feather-picking behavior and weight loss -- Case 12. A 14-year-old parrot with weakness, anorexia, and labored breathing -- Case 13. A 4-year-old parrot with anorexia, weakness, and lethargy -- Case 14. An adult vulture with generalized weakness -- Case 15. A 2-year-old tragopan with wounds -- Case 16. A 5-month-old chicken with lethargy -- Case 17. A 4-year-old budgerigar with generalized weakness and breathing heavily -- Case 18. A 41/2-year-old duck with acute dyspnea -- Case 19. A 14-year-old falcon with anorexia -- Case 20. An 8-month-old hawk with anorexia, weakness, and vomiting -- Case 21. A juvenile kestrel with a drooping right wing and blood in the left nares -- Section 3: Herptile Hematology Case Studies -- Case 22. A 20-year-old turtle with lethargy and anorexia -- Case 23. A 3-year-old lizard with lethargy and keeping the eyes closed -- Case 24. An 18-month-old lizard with an oral mass
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Lethargy and weakness are common presenting signs in first-opinion practice but can be difficult to distinguish for both the owner and clinician. They may be primary signs but are more commonly secondary to another disease process. Many conditions can result in lethargy and/or weakness, and in order to determine the exact cause of the signs, a full history should be obtained and clinical examination and diagnostic work-up performed. This chapter looks at history, physical examination, differential diagnosis, diagnostic tests and endocrine disorders causing lethargy and weakness.
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A Young Boy With High Fever and Lethargy A 5-year-old boy is brought to the emergency department (ED) by his parents. They report that, for the past week, the child has had a high fever (temperature up to 40oC [104oF]), generalized weakness, lethargy, and lack of appetite. The boy’s eyes are bloodshot and he has refused food and drink. The child has no history of cough, shortness of breath, hematemesis, melena, headaches, vision problems, or seizures. He has not been in contact with sick persons, has not traveled abroad, does not have a pet, and is not taking any medications. His immunizations are up-to-date.
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Introduction: Infarct-induced lethargy is a common disabling symptom that lacks a consensual definition and a standardized method of care. Identifying the causes of the infarct in the thalamic reticular nucleus (TRN) induced lethargy is crucial in stroke patients. Case presentation: A 68-year-old female patient was admitted to the hospital with lethargy and weakness in the right limb. A computed tomography (CT) scan performed at the presentation showed no bleeding. She was given intravenous thrombolysis. A head computed tomography (CT) scan clearly showed that the infarct was located in the TRN. After 1 hour of treatment, the weakness in the patient’s limb was relieved. However, she was still lethargic, but her lethargy symptoms improved after 3 days. Discussion and conclusions: Our case highlights that despite the small size of the infarct, the patient was unconscious, which makes it difficult for physicians to understand and treat the condition, resulting in trouble managing the case. We performed a literature review and proposed that the infarction located in the TRN causes lethargy. However, further clinical and pathophysiological research is still needed to improve patient care.
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From the above protocols, it can be seen that the clinical picture of poisoning was very similar in all animals. Usually the first symptom was lethargy, to which inactivity was added; lethargy intensified and at times passed, as it were, into a stunned state. Dispatch of the gastrointestinal canal was not built up significantly and for a short time, and in cats, more or less pronounced salivation appeared.
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The most common cause of malignant hypertension in children is renal or renovascular pathology. The combination with lethargy suggests a diagnosis of hypertensive crisis with hypertensive encephalopathy. Here, we present a case of severe hypertension with lethargy as the sole presenting symptoms of ileocecal intussusception. Both normalized following surgical repositioning. We conclude that malignant hypertension and lethargy can be presenting symptoms of intussusception.
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