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Carbon Monoxide Intoxication: A Case of Misdiagnosis with Neuroradiological Follow Up

Chiara Davico, Donata Notari, Paola Larosa, Federica Ricci, Roberta Vittorini, Maurizio Cogoni and Marina Gandione

Carbon monoxide (CO) intoxication is one of the main causes of poisoning in industrialized countries and it often leads to diagnostic errors, because of its presenting symptoms, extremely aspecific and confounding. We describe the case of a previously healthy 4-months-old infant, who presented with an abrupt loss of acquired developmental achievements. Many confounding elements brought to an initial misdiagnosis and consequently an absence of appropriate and timely therapy. Neuroradiological and clinical evolution were subsequently fundamental in ascertaining CO intoxication. We report clinical and MRI follow up at six months from onset, underlying a severe developmental delay, in spite of a complete normalization of MRI scan. We provide an overview on published literature on the topic, which further reminds that in front of an acute onset of neurological symptoms CO intoxication should be always taken into account.