Death from paracetamol overdose despite appropriate treatment with n‐acetylcysteine

摘要

A case of death from severe paracetamol poisoning which presented early and received appropriate treatment according to evidence‐based guidelines is presented here. It is very rare for patients to die from paracetamol poisoning when they receive N‐acetylcysteine (NAC) within 8 h of ingestion. The patient had a marked lactic acidosis on presentation to hospital. This case demonstrates that a patient can die from paracetamol poisoning despite early and appropriate treatment, and raises the question whether lactic acidosis in a patient following paracetamol overdose should prompt the initiation of NAC treatment while awaiting paracetamol levels.