![]() ![]() Her vital parameters, blood investigation reports and arterial blood gas analysis is given below. Since chest skiagram showed no evidence of aspiration and considering the possibility of peppermint oil ingestion causing nephrotoxicity, further dose of gentamycin was stopped. The medication administered include inj ranitidine intravenous (iv), inj ceftriaxone iv, inj gentamycin iv, inj metoclopramide iv and antacid through naso-gastric tube. A 7.0 Fr triple lumen central venous catheter was inserted through right subclavian vein. Warming blanket and radiant warmer were applied. In the mean time all her clothes were changed and wet sponging was done. Thus, intra-venous infusion of dopamine was started, which was gradually increased to 10 μg/kg/min. Rapid intravenous infusion of crystalloid was started but her blood pressure did not improve. Gastric lavage was done with warm normal saline. Mechanical ventilation (SIMV mode) was instituted (FiO2-1). ![]() Patient was immediately intubated without any resistance. Auscultation of chest and precordium revealed normal vesicular breath sounds and normal heart sounds. Her peripheral pusles were absent and extremities were cold and clammy. Clincal examination revealed that the patient was comatosed, had a heart rate of 60/minute, blood pressure not recordable, respiratory rate of 6-8/ minute, oxygen saturation of 30%. The exact amount ingested could not be ascertained. A strong smell of mint was emanating from her body. We describe for the first time a near fatal case of poisoning due to oral peppermint ingestion.Ī 40 year old female who was brought to the emergency room was suspected to have ingested PPMT oil. Herbal medicines like menthol oil (constituent of PPMT oil) are increasingly acknowledged due to the ever increasing use of herbal remedies amongst general population in developed and developing countries worldwide. High doses could be hepatotoxic and nephrotoxic (rarely interstitial nephritis and acute renal failure). Its side effects are claimed to be usually mild and minimally toxic (gastro esophageal reflux, heartburns, nausea, vomiting, allergic reactions and diarrhea). It is also used as a flavoring agent in many products. It is commonly recommended for a variety of ailments like common cold, irritable bowel syndrome, non-ulcer dyspepsia, headache, etc. The active constituents are menthol, menthone, cineol, pulegone and several other volatile oils. It is obtained from the stem, leaves and flower of the plant. piperita is a hybrid of spearmint (Mentha spicata) and water mint (Mentha aquatica). Peppermint oil (PPMT) (Mentha piperita) is easily available organic oil. ![]()
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