Suspected Endotoxin Poisoning In Two Intravenous Methamphetamine Users

The effects of methamphetamine used as a rec-reational drug include central nervous system stimulation that can induce euphoria, increased alertness, intensity of emotions, anorexia, and in-creased sexuality.! In toxic doses methamphetamine induces agita-tion, anxiety, hallucinations, delirium, seizures, and even death. Hyperthermia can result from drug-induced central nervous system abnormalities, muscular hyperactivity, or seizures. Cardiovascu-lar complaints include chest pain, palpitations, and dyspnea,2,3 and dysrhytlunias, tachycardia, hyperten-sion, and myocardial ischemia are not uncommon.4,5 We report the cases of two patients who arrived and were admitted to our hospital at the same time, both manifesting some of the above-de-scribed effects, but whose conditions were accom-panied by some abnormalities not usually seen with methamphetamine. These effects included hypotension, pulmonary edema with hypoxia, and an initial leukopenia followed by leukocytosis. These manifestations might be more easily ex-plained by hypothesizing that an endotoxin was a contaminant in the drug used