Intoxication by Massive Ingestion of Poppers: A Case Report

Background: Poppers are commonly inhaled for their recreative properties. Oral intakes are scarce, and clinical presentation and management of massive ingestions are poorly described in literature. We report a haemodynamic failure due to massive oral intake of poppers, and its evolution. Case presentation: A 47 years old healthy man drank by mistake about 5 mL of poppers. Respiratory and haemodynamic failures grew quickly; requiring admission in intensive care unit, oxygen therapy, volume expansion and norepinephrine up to 2 mg/h. Methaemoglobinemia reached 32% and required methylene blue infusion, falling to less than 5% after 6 hours. Respiratory failure gradually improved, as well than hypotension allowing norepinephrine withdrawal in the first 24 hours. Patient was then promptly discharged at home without any aftereffect. Conclusions: This case mainly brings to light the strong hemodynamic effect of a massive oral intake of poppers and its fast kinetics, poorly described in literature. Physiopathological mechanisms involved and pharmacological properties of aryl-nitrites are fully compatible with our clinical observation.