Neurological deficit associated with Mycoplasma pneumoniae reversed by plasma exchange.

Abstract

kPa (78 mm Hg), carbon dioxide pressure 3-3 kPa (25 mm Hg), bicarbonate concentration 14-0 mmol/l, and pH 7-4.She was admitted to the intensive care unit and within 12 hours had regained consciousness.Renal and hepatic function remained normal throughout the illness.When her home was searched a strong-smelling substance in a rum bottle was found.Toxicological analysis confirmed that this was not rum but butanone (methyl ethyl ketone).Gas-liquid chromatography showed butanone to be present in her plasma in high concentration (13-2 mmol/l (95 mg/100 ml)) and in her urine.The plasma lactate concentration in blood taken at the time of admission was also raised (14-3 mmol/l (129 mg/100 ml)).She made a complete and uneventful recovery and was discharged from hospital after one week.She denied having swallowed anything unusual.We can only presume that she had sought solace from her chickenpox rash but that the rum bottle had inadvertently been filled with butanone.