Chronic salicylate poisoning

Chronic aspirin or other salicylate poisoning is uncommon, but can occur in patients who ingest more than 100 mg/kg/day of aspirin or who repeatedly apply salicylate-containing creams to broken skin. Risk factors for chronic salicylate poisoning include older age, chronic kidney disease and chronic liver disease.

The onset of chronic salicylate toxicity is insidious and it can be misdiagnosed. Clinical effects include dizziness, delirium, dehydration, fever, metabolic acidosis and coagulopathy. The presentation can mimic septicaemia. Complications include pulmonary and cerebral oedema, and acute kidney injury.