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Fatality from potassium gold cyanide poisoning
  1. Elizabeth Harmon,
  2. Jacob Lebin,
  3. David Murphy and
  4. Bjorn Watsjold
  1. Emergency Medicine, University of Washington, Seattle, Washington, USA
  1. Correspondence to Dr Elizabeth Harmon, eaharmon{at}


While potassium cyanide poisoning has been well described, the toxicity of potassium gold cyanide is less well understood. This case describes an 84-year-old man who presented after an intentional ingestion of 0.5–1 teaspoons of potassium gold cyanide. Despite antidotal therapy, the patient rapidly developed severe lactic acidosis, multiorgan dysfunction and ultimately expired. While the patient’s clinical findings were consistent with acute cyanide poisoning, a serum cyanide level was below the toxic threshold. Previous reports have suggested that gold toxicity may also contribute to the effects of potassium gold cyanide, and may have played a role in the patient’s rapid decline. In addition to treatment of cyanide toxicity, management of acute gold toxicity should also be considered in potassium gold cyanide ingestion.

  • emergency medicine
  • poisoning

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  • Contributors All the listed authors contributed to the writing, research and revision of the manuscript. EH, BW and DM saw and cared for the patient in the emergency department. EH did the preliminary literature review and writing of the manuscript. JL made significant contributions and revisions to the manuscript and obtained the photos. BW obtained consent from the patient’s family. DM, BW, EH and JL all made multiple revisions to the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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