Can you make the diagnosis?

John and Sara are spending a weekend in their cabin in the woods.  They plan to go cross-country skiing tomorrow, but tonight are enjoying sitting around their wood-burning stove and having a glass of wine.

Later that night, John starts getting a headache, and takes two Advil.  Sara sees him taking the Advil and asks for some as she also has a headache.  They both feel very sleepy by 8 pm and decide to go to bed early.

That night John wakes up and feels nauseated.  He runs to the bathroom to vomit.  He calls for Sara to bring him a washcloth, but she only mumbles and falls back to sleep.

What do John and Sara have?

  1.  Influenza
  2.  Food poisoning
  3.  Carbon monoxide poisoning
  4.  Alcohol intoxication.



If you guessed 3, carbon monoxide poisoning, you are correct.

Carbon monoxide, or CO, is found in fumes from car engines, stoves, lanterns, grills, fireplaces, wood burning stoves, gas ranges and furnaces.  When CO builds up in an enclosed space,  it can cause CO poisoning.  Symptoms include headache, weakness, nausea, vomiting, chest pain, and confusion.  Each year, more than 20,000 Emergency Department visits and  400 deaths result from unintentional CO poisoning.

Influenza can cause symptoms similar to carbon monoxide poisoning.  But whenever two people have symptoms at the same time, carbon monoxide must be suspected.  Food poisoning symptoms again can be similar to carbon monoxide poisoning, though a headache would be unusual, and food poisoning is typically associated with diarrhea.  Alcohol intoxication is a possibility, but in this case the couple had not consumed a large amount of alcohol.

wood stove.jpeg

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