Lead Poisoning presenting as acute severe myalgia: Why was the diagnosis delayed and what lessons can we learn as acute physicians?
Petterson, T.; McLaren, J.; McGouran, D.
Acute Medicine 9(1): 24-26
2010
ISSN/ISBN: 1747-4892 PMID: 21597564 Document Number: 13337
Patients presenting to the "front door" with acute neuromuscular symptoms are challenging. Toxins need consideration as possible causative agents if there is the possibility of relevant exposure. This requires a thorough history1 and an awareness of local ethnic, social and industrial cultures within the practice locality. We describe a case of lead poisoning in a 35 year old man who presented with severe, progressive, myalgia. We consider that basic errors in clinical processing delayed a potentially difficult and serious diagnosis and these are discussed. The importance of maintaining a thorough initial clerking process within the Acute Medical Unit is highlighted. This should include a comprehensive occupational history. Acute physicians should familiarize themselves with local industry and the toxic syndromes they can produce.
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