A Case of Fever, Impaired Consciousness, and Psychosis Caused by Nitrous Oxide Abuse and Misdiagnosed as Acute Meningitis.
Journal of Nippon Medical School = Nippon Ika Daigaku zasshi November 7, 2023 Naoto Matsuda, Hiroaki Wakakuri, Kazuyuki Uehara et al.
A case of fever and impaired consciousness in a patient with a history of nitrous oxide (N2O) abuse is described. N2O is readily available and its recreational abuse has become a social problem, though in Japan, where non-medical use is strictly prohibited, abuse is often overlooked due to lack of clinical experience. N2O abuse can cause long-term symptoms including vitamin B12 deficiency, myelopathy, myeloneuropathy, subacute combined degeneration, mood changes, and psychosis. Diagnosis is difficult because the compound has a short half-life and is rapidly eliminated through the lungs.