A case of fever, impaired consciousness, and psychosis caused by nitrous oxide abuse and misdiagnosed as acute meningitis

J Nippon Med Sch. 2022 Nov 25. doi: 10.1272/jnms.JNMS.2023_90-505. Online ahead of print.


Nitrous oxide (N2O) is readily available, and its abuse for recreational purposes has become a social problem. In Japan, where N2O is strictly prohibited for non-medical use, abuse is often overlooked due to a lack of experience in the field. N2O abuse causes various long-term symptoms, including vitamin B12 deficiency, myelopathy, myeloneuropathy, subacute combined degeneration, mood changes, and psychosis. The diagnosis of N2O abuse is difficult due to the compound's short half-life and rapid elimination through the lungs. This report describes a case of fever and impaired consciousness in a patient with a history of N2O abuse.

Keywords: N2O; impaired consciousness; substance use disorder.