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Case Reports in Emergency Medicine
Volume 2012, Article ID 162387, 3 pages
http://dx.doi.org/10.1155/2012/162387
Case Report

Undifferentiated Altered Mental Status: A Late Presentation of Toxic Acetaminophen Ingestion

Department of Emergency Medicine, Yale University, 464 Congress Avenue, Steuite 260, New Haven, CT 06519-1315, USA

Received 24 February 2012; Accepted 22 May 2012

Academic Editors: Y. Inoue and Y.-F. Wang

Copyright © 2012 Thomas E. Robey and Edward R. Melnick. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Altered mental status is a common undifferentiated presentation in the emergency department. We describe a case of acetaminophen-induced acute liver failure that was diagnosed and treated prior to obtaining definitive historical or laboratory information about the etiology. The physical exam finding of scleral icterus in this case was a key element to rapid identification and treatment of this life-threatening condition. A discussion of appropriate N-acetylcysteine treatment for acute liver failure and acetaminophen intoxication is included.