Ghost tablet in feces.

Recently, we encountered a female patient who identified the presence of a ghost tablet in her fecal matter. Interestingly, although the patient was prescribed potassium chloride capsules, elemental composition analysis by energy-dispersive X-ray spectroscopy was unable to detect the presence of either potassium or chloride in the fecal tablet remnant.

A 29‐year‐old Japanese female presented at our institution after having identified the remnants of a tablet in her feces (Figure 1A). Two years prior to this encounter, the patient had received lung transplantation due to idiopathic pulmonary arterial hypertension. The fecal tablet remnants appeared similar to the potassium chloride tablet (Figure 1B) prescribed for the patient. Although energy‐dispersive X‐ray spectroscopy identified high concentrations of both potassium (Figure 2B, arrow) and chloride (Figure 2B, arrowhead) in samples obtained from the potassium chloride tablets, neither element was detectable in the fecal tablet remnants (Figure 2A). Therefore, we classified these remnants as a ghost tablet. Generally, potassium chloride tablets are designed for sustained release of the medication over prolonged periods following ingestion. However, these prolonged‐release tablets may be composed of insoluble materials and are subsequently excreted through fecal matter. These are commonly termed “ghost tablets” or “ghost pills”.1, 2

Figure 1

Photographs of a ghost tablet and a potassium chloride tablet. The remnants of a tablet in her feces (A) appeared similar to the potassium chloride tablet (B)

Figure 2

Spectra obtained by energy‐dispersive X‐ray spectroscopy. High concentrations of both potassium (B, arrow) and chloride (B, arrowhead) were identified in the potassium chloride tablets. However, neither element was detectable in the fecal tablet remnants (A)

CONFLICT OF INTEREST

The authors have stated explicitly that there are no conflicts of interest in connection with this article.