Bismuth Toxicity: A Rare Cause of Neurologic Dysfunction
Paul T. Reynolds, Kathleen C. Abalos, Jennifer Hopp, Mark E. Williams
DOI: 10.4236/ijcm.2012.31010   PDF    HTML     15,818 Downloads   23,319 Views   Citations


Bismuth subsalicylate (Pepto-Bismol?) and other bismuth-containing compounds have been used for many years to treat gastroenterological complaints. Although safe in the majority of patients, bismuth can cause a well-described toxic state marked by progressive neurological decline. Features of bismuth toxicity include confusion, postural instability, myoclonus, and problems with language. This presentation can masquerade as other causes of progressive neurologic dysfunction including Creutzfeld-Jakob Disease (CJD), Hashimoto’s Encephalopathy, and others. In this case study, we present a patient who was using bismuth salicylate in toxic quantities to help control diarrhea. On initial presentation, several diagnoses were entertained before bismuth levels were obtained. This case study highlights the fact that bismuth toxicity, while rare, should be considered in a patient with progressive neurological decline. Also, we hope this case reminds physicians of a severe consequence of a common, readily available medication.

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P. Reynolds, K. Abalos, J. Hopp and M. Williams, "Bismuth Toxicity: A Rare Cause of Neurologic Dysfunction," International Journal of Clinical Medicine, Vol. 3 No. 1, 2012, pp. 46-48. doi: 10.4236/ijcm.2012.31010.

Conflicts of Interest

The authors declare no conflicts of interest.


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