SALICYLATE POISONING IN PEDIATRIC-PATIENT S IN TUNIS - EPIDEMIOLOGY, CLINICAL-FEATURES AND OUTCOMES IN 57 CASES

A retrospective study of children with salicylate poisoning managed fr om 1985 through 1992 in two general pediatrics departments in Tunis, T unisia, identified 57 cases (mean age 22 1/2 months). Salicylate poiso ning accounted for 13.5% of all cases of acute drug poisoning. The mor bidity rate was 1.6/1000. Salicylates were given for more than 12 hour s in 91 % of cases, usually without a physician's prescription (81 % o f cases). The diagnosis was considered at presentation in only 31 % of cases. Symptoms were mild in all the patients who took salicylates fo r less than 12 hours (mean plasma level of salicylate, 280 mg/L). Of t he patients who received excessive doses for more than 12 hours (mean plasma salicylate level, 474 mg/L), 12 had mild symptoms, 19 had moder ate symptoms, and 21 had severe symptoms. Gastrointestinal, respirator y, and neurological symptoms were the main manifestations. Metabolic a cidosis was present in every case and respiratory alkalosis in 69 % of cases. Mortality was 15.8 %, and all the patients who died had receiv ed salicylates for more than 12 hours. Other factors of adverse progno stic significance were patient age younger than one year and a delay i n instituting therapy.