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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The smell of bitter almonds is characteristic but is not always present. Cyanosis is absent and the skin may be brick red in colour.

The effects of acute poisoning may include:

  • hypoxia, hypotension, tachycardia
  • headache, vomiting, weakness
  • chest tightness, dyspnoea, hyperventilation, pulmonary oedema
  • confusion, vertigo, ataxia, convulsions, coma, paralysis
  • cardiac arrhythmias
  • metabolic acidosis

Chronic poisoning may present with:

  • ataxia, optic atrophy, nerve deafness, peripheral neuropathy, dermatitis

Toxic amblyopia may result from the cyanide component of tobacco smoke.

At points of skin contact, there is irritation, redness and pain, and, sometimes, burns. The chemicals are absorbed through the skin causing a picture similar to that seen from direct inhalation or ingestion.


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The content herein is provided for informational purposes and does not replace the need to apply professional clinical judgement when diagnosing or treating any medical condition. A licensed medical practitioner should be consulted for diagnosis and treatment of any and all medical conditions.

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