Cane toads and bush tucker: starvation ketoacidosis in a bushwalker.

Content Provider	Semantic Scholar
Author	Wongseelashote, Sarah Quilty, Simon Johnston-Leek, Malcolm
Copyright Year	2013
Abstract	An otherwise fit and healthy 35-year-old woman presented to our emergency department at a remote Northern Territory hospital with vomiting and abdominal pain. An independent traveller from a southern Australian city, she had embarked 10 days earlier on a solo bushwalk into an isolated national park with the intention of living on “bush tucker” — wild plants, berries and native animals that she would find along the way. She had not sought any advice from authorities or local people before commencing her bushwalk. She followed the path of a river from which she drank fresh water throughout her journey. By Day 4 she had completely consumed her small supply of food and began eating berries that she identified using a popular Australian pictorial guide.1 On Day 6, being extremely hungry, she ate a frog that leapt into her tent, which she subsequently grilled over a spirit flame. She immediately developed nausea and vomiting and became acutely aware of the distance to medical care and her serious predicament. Still vomiting intermittently and without any food, she embarked on a 4-day march that we estimate to be around 100 kilometres to a campsite with a public telephone, where she called an ambulance. On arrival at the hospital she was diaphoretic, nauseated and anxious. She had sunburn on exposed areas and had multiple insect bites and abrasions. Apart from a respiratory rate of 26 breaths/min, her vital signs were normal and the only abnormality on physical examination was mild epigastric tenderness. Initial venous blood gas examination showed severe metabolic acidosis with respiratory compensation (Box). Electrolytes, renal function, liver function and creatine kinase were all within normal limits, as was an electrocardiogram. She received 2 L of intravenous normal saline and a sandwich, and her symptoms rapidly improved. She was admitted and given breakfast, lunch and dinner. Eight hours later, her pH had normalised and the following day she was discharged.
Starting Page	393
Ending Page	400
Page Count	8
File Format	PDF HTM / HTML
Alternate Webpage(s)	https://www.mja.com.au/system/files/issues/199_11_161213/won10204_fm.pdf
PubMed reference number	24329662v1
Volume Number	199
Issue Number	11
Journal	The Medical journal of Australia
Language	English
Access Restriction	Open
Subject Keyword	Abdominal Pain Acidosis Ambulances Anura Berries Creatine Kinase Eating Disorders Electrocardiography Fresh Water Hospital admission Insect Bites Ketosis Kidney Diseases Liver diseases Nausea and vomiting Physical Examination Portion of respiratory air Respiratory rate Sore to touch Sunburn bite injury breaths per minute epigastric tenderness
Content Type	Text
Resource Type	Article