Acute chloroquine poisoning: old recommendations but aggressive management.
Introduction: Chloroquine is a molecule used in the treatment and prevention of malaria. It can be present in quantity at home because of the increase of the journeys in malarious zones, with increased risk of exposure to the voluntary or involuntary poisonings. Mortality and morbidity are important for a dose greater than 4 g. Through the management of a patient suffering from a chloroquine poisoning, we try to show the need for early identification of its severity and appropriate medical management.
Case report: 35-year-old female patient who has been intentionally intoxicated by ingestion of a potentially lethal dose of chloroquine. Pre-hospital care, from home to hospital, is reported with iconography.
Discussion/Conclusion: We recall the main physiopathological characteristics of chloroquine, whose main attack is cardiac before a multivisceral failure, and the treatment modalities of intoxication, whose recommendations are already old. In particular, the combination of diazepam epinephrine and mechanical ventilation could reduce mortality. The use of the extra corporeal oxygenation membrane (ECMO) meets specific criteria and can be beneficial for the most serious cases refractory to conventional therapies.
This observation highlights the deployment of a real ""chain of survival"". The vital emergency was recognized immediately. Its early and aggressive pre-hospitalization has allowed regulation on a specialized resuscitation center, fundamental to survival. The professional synergies with dynamic cooperation of the different actors allowed the optimization of the conditions of care of the patient.
