Salicylates

Salicylates are a common cause of poisonings in the United States. Salicylates are readily available in OTC products such as aspirin, Pepto-Bismol (bismuth subsalicylate), and oil of wintergreen (methyl salicylate). Salicylate poisoning is frequently misdiagnosed, particularly when chronic poisoning exists. Symptoms and signs are often nonspecific, and erroneous diagnoses such as "sepsis," "altered mental status," "gas­troenteritis," or "CHP' are not infrequently made.

Causes

Salicylates found in food may cause a similar reaction if consumed in high amounts by a person with Salicylate intolerance. A Salicylate-free diet can help to prevent these reactions and may also improve the clinical symptoms of asthma and skin rash in some cases.

Symptoms

• Mild or early poisoning (1 to 12 hours after acute ingestion): nausea, vomiting, abdominal pain, headache, tinnitus, dizziness, fatigue
• Moderate or intermediate poisoning (12 to 24 hours after ingestion): fever, sweating, deafness, lethargy, confusion, hallucinations, breathlessness
• Severe or late poisoning (greater than 24 hours after acute ingestion or unrecognized, untreated chronic ingestion): coma, seizures, fever

Signs

• Mild or early: lethargy, ataxia, mild agitation, hyperpnea, mild abdominal tenderness
• Moderate or intermediate: fever, asterixis, diaphoresis, deafness, pallor, confusion, slurred speech, disorientation, agitation, hallucinations, tachycardia, tachypnea, orthostatic hypotension
• Severe or late: dehydration, coma, seizures, hypothermia or hyperthermia, tachycardia, hypotension, respiratory depression, pulmonary edema, arrhythmias, papilledema

Treatment

Aspirin should not be given to children under 16 years of age unless specified by a Doctor. Aspirin should be avoided in children aged 12 to 15 if they are feverish.

An intolerance to Salicylates is a relatively common condition which can be managed by avoiding foods which contain these substances. The main food sources of Salicylates are fruits, vegetables, dried spices, tea and food flavourings