Citation

John EM, Kolisambeevi AA, Pournami F, Prithvi AK, Nandakumar A, Prabhakar J, Jain N. Indian J. Pediatr. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, K C Chaudhuri Foundation and All India Institute of Medical Sciences, Publisher Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s12098-022-04242-9

PMID

35595926

Abstract

India faces myriad, inconceivable issues on the medical front. We received a critically ill young infant, with acute onset multiorgan dysfunction syndrome (MODS): encephalopathy, respiratory and hepatic failure, shock, and acute kidney injury. Differentials considered were sepsis (bacterial/viral), inborn errors of metabolism, hemophagocytosis, critical congenital heart disease, and endocrinopathies. To rule out these, investigations including polymerase chain reaction for pathogens and tandem mass spectrometry (TMS) were done but they did not conclusively support any of the above. Continued parent communication revealed history of oral/nasal instillation "therapy" with indigenous oil and plant-based concoctions for a minor cold.

Intensive care supports to combat organ damages included ventilation for lipoid pneumonia, antibiotics, inotropes, fluid management, and blood product transfusions. Urine gas chromatography (GC) revealed dicarboxylic aciduria. Albeit this would form a basis for considering organic academia; these molecules are found in large concentrations in rancid oils (including medium chain triglycerides) and plant products [1]. These red herrings may be taken into consideration by intensivists...

Language: en