Woman shoots at "dead people" in Michigan

A 65-year-old woman in Michigan was admitted to the hospital after opening fire on individuals she believed were dead, according to a report in the scientific journal Clinical Practice and Cases in Emergency Medicine. She was calm and fully awake when she arrived at the emergency room and requested to meet with a psychiatrist, explaining that she had been seeing apparitions and had shot at "dead people."

No psychiatric history found

The doctors found no known psychiatric history in the patient. She had several chronic health conditions, including high blood pressure, diabetes, heart failure, and persistent lower back pain. However, she had no prior psychiatric issues. Blood tests and a toxicological screening were conducted, revealing a slight metabolic acidosis and abnormally high levels of salicylates in her system. Salicylates are found in aspirin.

Chronic aspirin poisoning suspected

The patient later admitted to taking more than 15 aspirin tablets per day for several weeks, each containing 500 mg of active ingredient, resulting in a daily intake of over 7.5 grams of aspirin. This led the doctors to suspect chronic aspirin poisoning. Another symptom, tinnitus, or ringing in the ears, which is characteristic of aspirin poisoning, further supported this diagnosis.

Treatment and recovery

Following consultation with the Michigan Poison Control Center, the medical team administered intravenous sodium bicarbonate to alkalinize the blood and urine, facilitating the elimination of salicylates by the kidneys. Within a few hours, the salicylate levels in her blood began to decrease. Over the next 48 hours, her tinnitus and hallucinations gradually disappeared, and she was able to return home without needing psychiatric consultation.

Aspirin poisoning mimics psychiatric illness

The case highlights how chronic aspirin poisoning can mimic psychiatric illness, with symptoms such as visual hallucinations being less commonly recognized compared to tinnitus or digestive issues. The authors of the report suggest that prolonged exposure may disrupt the blood-brain barrier, allowing substances to pass from the blood to the brain. The case serves as a reminder for doctors to consider medication poisoning when patients present with hallucinations or psychotic symptoms, as the cause may not always be an illicit substance or rare medication, but a commonly used product like aspirin.