Differential Diagnosis Cyanosis Versus Argyria: When Your Patient Remains Blue—A 48-year-old Trauma Patient With Persistent Cyanosis

Travis presents a medical case abut the 48-year-old man who was diagnosed with argyria, a permanent, dark discoloration of the skin caused by the use of medicinal silver preparations. Patients with argyria have skin discoloration that ranges from gray to silver to blue in appearance. The most commonly affected skin sites are those routinely exposed to the sun, but discoloration occurs in non-exposed areas as well. Topical silver preparations can produce discoloration, but most cases of widespread argyria are associated with colloidal silver ingestion. Chronic consumption leaves permanent silver deposits on the skin and visceral organs. Other argyria effects include corneal and conjunctival silver deposition. The toxic effects of oral silver exposure include altered mental status and seizures. Therefore argyria may have contributed to this patient's injuries by lowering his seizure threshold in the presence of intracranial hemorrhage. Pneumonia complicated ventilator weaning, and the patient remained in the TSICU for approximately 3 weeks.