Salicylates are widely used and are easily available as over-the-counter medications; thus, they can be readily abused. Although acute toxicity can be readily diagnosed if an ingestion history is provided, both acute and chronic salicylate toxicity often goes unrecognized, with high mortality when the patient is not treated properly. Salicylates should be considered in the differential diagnosis of an adult patient with acid-base abnormalities of uncertain cause, especially when there are concurrent neurologic symptoms. Patients with salicylate toxicity are treated with alkaline diuresis and sometimes dialysis. The prognosis depends on prompt recognition and treatment. Delayed diagnosis results in increased morbidity and mortality, particularly in the elderly.
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