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Previous Volume 349:1267-1275 September 25, 2003 Number 13 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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Presentation of Case

Dr. Joshua N. Goldstein (Emergency Medicine): A 21-year-old man was brought to the emergency department because of a sudden change in mental status.

On the evening of admission, the patient had been consuming alcohol with friends. They noted that he had begun to act strangely, becoming uncommunicative and incontinent of urine and stool, and thought that he might have had a brief seizure. They called an ambulance. When emergency medical services arrived, the patient was awake but uncommunicative and unable to follow commands. The glucose level in a finger-stick blood sample was normal. An intravenous catheter was placed, and the . . . [Full Text of this Article]

Diagnosis and Management

Stabilization and Sedation

Provisional Diagnosis

Gastrointestinal Decontamination

Pathophysiology and Management of -Hydroxybutyrate Intoxication

Final Diagnosis

Source Information

From the Department of Emergency Medicine, Massachusetts General Hospital (D.N.T.); the Department of Emergency Medicine, Children's Hospital (M.W.S.); and the Departments of Medicine (D.N.T.) and Pediatrics (M.W.S.), Harvard Medical School — all in Boston.

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