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To raise clinicians' awareness of chronic (therapeutic) salicylate poisoning as a common cause of admission in paediatric patients presenting to hospital with respiratory distress (a clinical manifestation of metabolic acidosis) and a history of 'over the counter' treatment with salicylate (Aspirin). We present two complex cases and provide a review of the literature on pathogenesis, clinical presentation and management of salicylate poisoning. A complete history of the illness, including questions on drug use, is vital in assessing the cause of metabolic acidosis in children. Due to the limited options available in managing such patients in many developing countries, emphasis should be placed on prevention of poisoning by educating the community and health care providers.

Original publication





East African medical journal

Publication Date





159 - 163


Kenya Medical Research Institute, Centre for Geographic Medicine Research, Coast, P.O. Box 230, Kilifi, Kenya.


Humans, Fever, Salicylates, Treatment Outcome, Fatal Outcome, Child, Preschool, Male, Nonprescription Drugs, Drug Overdose