Cardiovascular collapse following povidone-iodine wash

Abstract

We present a case study of a severe episode of iodine toxicity following povidone-iodine wash with clinical manifestations of cardiovascular collapse, metabolic acidosis, renal failure and seizures. Povidone-iodine has been used as a medical antiseptic and disinfectant since 1952. Iodine toxicity secondary to povidone-iodine use is rare. Iodine toxicity is difficult to diagnose and the diagnosis is made by a high index of suspicion. Toxicity due to iodine correlates with serum and urine iodine levels. Treatment of iodine toxicity is supportive. A review of literature relating to the components of povidone-iodine, iodine metabolism, its manifestations and management of iodine toxicity secondary to povidone-iodine is also presented. An Ovid-Medline search from 1950 to 2009 revealed 1236 articles on the clinical manifestations of povidone-iodine usage but no article on iodine toxicity relating to povidone-iodine based on the following search criteria: povidone-iodine and/or iodine toxicity secondary to povidone-iodine (limited to English language, review articles, full text and human patients).