Seizures in a Patient Treated with Continuous Povidone–Iodine Mediastinal Irrigation

To the Editor: Continuous mediastinal irrigation with povidone—iodine is a standard treatment for mediastinal infection occurring as a complication of cardiac surgery.¹ However, systemic absorption of iodine during mediastinal irrigation or topical treatment may cause toxic side effects, including electrolyte disturbances, renal failure, and changes in mental status.^{2 3 4 5} Seizures are recognized as a toxic effect of parenterally administered iodinated contrast agents used for radiologic imaging.^{6 , 7} We describe a patient with seizures that occurred in association with continuous mediastinal irrigation with povidone-iodine. A 62-year-old man was admitted with persistent angina one week after a myocardial infarction. He had previously had…