Unrecognized adult salicylate intoxication.

Adult salicylate intoxication has been considered to be easily recognized and assciated with low morbidity and mortality. In the present study of 73 consecutive adults hospitalized with salicylate intoxication, 27% of patients were undiagnosed for as long as 72 h after admission. The initial physical findings and laboratory data in patients not diagnosed on admission did not markedly differ from the findings in patients diagnosed on admission, and included tachypnea and acid-based disturbances as well as the frequent occurrence of neurologic abnormalities. However, patients with a delayed diagnosis of salicylate intoxication were older, rarely had a previous history of drug overdose, and more often became accidentally intoxicated while ingesting salicylate for associated medical illnesses when compared with patients diagnosed on admission. Moratlity was encountered with significantly greater frequency in patients with delayed diagnosis, and, consequently, delayed therapy, when compared with patients diagnosed on admission.