A Case Of Methamphetamine Toxicity In A Child With Pica
INTRODUCTION: Methamphetamine, a synthetic stimulant, acts on the central nervous system to increase monoamine levels and causes euphoria, wakefulness, and alertness for several hours. Pica is a feeding and eating disorder common in children between the ages of 2 and 3 and is characterized by the persistent consumption of nonfood substances. This case reports a pediatric incident of pica induced bowel obstruction with sepsis that was complicated by methamphetamine ingestion. Methamphetamine toxicity and bowel obstruction can present similarly in children; however, methamphetamine was not tested until the postmortem examination.
CASE DESCRIPTION: An 11 year old girl with a history of pica was found unresponsive in her home and pronounced dead after unsuccessful resuscitative efforts. Radiographic imaging showed multiple radio-opaque foreign objects in the stomach and bowel. Autopsy revealed foreign objects in her stomach and bowels: a green leafy substance, coins and other metallic items, folded papers, and plastics. Postmortem iliac blood and urine tested positive for methamphetamine and amphetamine.
DISCUSSION/CONCLUSION: This case emphasizes that the age range for suspected accidental drug ingestion should be expanded for those with pica, as these patients, despite being older, may not be able to differentiate between what they should and should not ingest. Furthermore, when treating a pediatric patient with pica that appears to present with bowel obstruction, unintentional drug ingestion should also be considered, particularly if there is a suspicion that the child lives in a household where drugs are abused, since drug toxicity presents similarly.