Delayed onset of impaired consciousness complicated with ketoacidosis after disulfiram overdose

BACKGROUND: We report a case of disulfiram overdose that caused a delayed onset of impaired consciousness and ketoacidosis. CASE PRESENTATION: A 61‐year‐old man was transferred to our hospital following a suicide attempt. The patient lost consciousness after an overdose of disulfiram and brotizolam. He was diagnosed with acute drug intoxication and was intubated. On day 2, he showed an improved consciousness response and was successfully extubated. On day 5, the state of consciousness worsened again, and ketoacidosis progressed. The patient required hemodialysis and suffered from impaired consciousness for the following 2 weeks. Eventually, he recovered gradually and was discharged to the rehabilitation ward. CONCLUSIONS: The delayed appearance of symptoms after the disulfiram overdose was thought to be related to the slow metabolism of disulfiram in the body. Our case suggests the necessity of careful follow‐up for delayed impaired consciousness.