Journal of Clinical Toxicology
Open Access

Abstract

An Unusual Case Report of Fatal Oral Ingestion of the Emerging “Bath Salt” Eutylone

Steven Fleming, Nicholas E. Goeders*, James C. Patterson II, Kenneth J. Manas and Kevin S. Murnane

Background: The abuse of novel psychoactive substances, such as synthetic stimulants, is increasing each year with modifications to drug scaffolds to alter pharmacokinetics or pharmacodynamics. Psychosis, cardiotoxicity, and excited delirium have been documented with intense sympathomimetic stimulants. The clinical recognition of these substances is challenging as routine blood and urine drug screening protocols do not readily detect the presence of these synthetic substances. We report an unusual case of oral ingestion of eutylone with subsequent confirmation of this substance.

Case details: A 49-year old female with history of chronic cardiovascular comorbidities, type 2 diabetes, depression, and end stage renal disease was presented to Emergency Department with 2-3 week history of abdominal distention with melenic stools. She was found to have onset ascites with melena prompting GI consultation. An esophagogastroduodenoscopy was performed revealing a white crystalline material obstructing mid oesophagus. A sample was obtained and the procedure was halted due to sever hemodynamic instability. To the best of our knowledge, there are no previous reports of fatal oral ingestion of eutylone by a 49-year old with no documented history of substance abuse.

Discussion: This case is concerning because eutylone is new substance that may not be detected during routine testing, is easy to obtain over the internet, and has the potential to cause mortality.

Published Date: 2021-07-13; Received Date: 2021-06-22