Diagnostic difficulties of a patient with sudden dizziness and suspected poisoning with household cleaning chemical: a case study

Abstract

Based on a properly conducted medical evaluation and physical examination, it is possible to determine the type of dizziness such as systemic associated with the damage of peripheral vestibular system or non‑systemic associated with a central vestibular dysfunction. This is essential as it determines the order of consultations and determines specific indications for hospitalisation in the department of otolaryngology or neurology. The article presents a case of a patient admitted to the Clinic as planned to complete otoneurological and audiological diagnostics. On the grounds of comprehensive medical evaluation and available medical documentation it was concluded that acute ailments in the form of dizziness and balance disorders first appeared about a month beforehand during cleaning work. Meanwhile, the concerned family called the emergency medical team, who based on the symptoms and suspecting poisoning from household cleaning chemicals referred and transported her to the Nofer Institute of Occupational Medicine in Łódź.
After performing an otorhinolaryngology physical examination and diagnostic tests, including laboratory, audiological, otoneurological and imaging tests, the following disorders were diagnosed: dizziness of mixed origin with decreased excitability of the middle ear labyrinth (affecting the left ear), moderate bilateral sensorineural hearing loss and unilateral tinnitus in the left ear.