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May 11, 1984

Carbon Monoxide Intoxication: Diagnostic Considerations

Author Affiliations

New Mexico Health and Environment Department Santa Fe
New Mexico Poison Center Albuquerque
University of Iowa Hospitals and Clinics Iowa City

JAMA. 1984;251(18):2350. doi:10.1001/jama.1984.03340420022018

To the Editor.—  The New Mexico Health and Environment Department and the New Mexico Poison Center frequently become involved in the investigation of accidental carbon monoxide (CO) intoxications. These investigations suggest that physicians should be reminded of three diagnostic considerations: the symptoms and time clustering of CO intoxications can be similar to those of food poisoning; a cherry red color of the skin and mucous membranes is not always present in CO intoxications; and some qualitative laboratory tests for carboxyhemoglobin (COHb) will not detect abnormal values.Group exposures to carbon monoxide may be misdiagnosed as food poisoning, especially if vomiting is present. As an example, we were requested to evaluate the conditions of a husband and wife and their 18-month-old son for presumed food poisoning. Both parents complained of nausea, vomiting, headache, dizziness, severe abdominal cramps, and diarrhea. The husband had experienced blurred vision and the wife had fainted. The