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lüll Death from paracetamol overdose despite appropriate treatment with N-acetylcysteine Bourdeaux C; Bewley JEmerg Med J 2007[May]; 24 (5): e31A case of death from severe paracetamol poisoning which presented early and received appropriate treatment according to evidence-based guidelines is presented here. It is very rare for patients to die from paracetamol poisoning when they receive N-acetylcysteine (NAC) within 8 h of ingestion. The patient had a marked lactic acidosis on presentation to hospital. This case demonstrates that a patient can die from paracetamol poisoning despite early and appropriate treatment, and raises the question whether lactic acidosis in a patient following paracetamol overdose should prompt the initiation of NAC treatment while awaiting paracetamol levels.|Acetaminophen/*poisoning[MESH]|Acetylcysteine/*therapeutic use[MESH]|Analgesics, Non-Narcotic/*poisoning[MESH]|Drug Overdose/complications/drug therapy[MESH]|Fatal Outcome[MESH]|Free Radical Scavengers/*therapeutic use[MESH]|Humans[MESH]|Male[MESH]|Middle Aged[MESH]|Multiple Organ Failure/chemically induced[MESH] |