Logo American Journal of Case Reports

Call: 1.631.629.4328
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo American Journal of Case Reports Logo American Journal of Case Reports Logo American Journal of Case Reports

06 June 2020 : Case report  USA

Underlying Serotonin Syndrome, Masked by Community-Acquired Pneumonia and Myocardial Ischemia

Unusual clinical course, Mistake in diagnosis, Diagnostic / therapeutic accidents

Royale Lim1ABCDEF*, Waqaar Arshad1AEF

DOI: 10.12659/AJCR.924109

Am J Case Rep 2020; 21:e924109

Abstract

BACKGROUND: Serotonin syndrome is a life-threatening condition that involves overstimulation serotonin receptors, which can be caused by medication overdose, drug-drug interactions, and regular doses of medications. It is often an overlooked diagnosis due to the presenting symptoms.

CASE REPORT: Our patient was a 79-year-old man with a past medical history significant for coronary artery disease status after coronary bypass surgery who presented to the Emergency Department with altered mental status. Vital signs were significant for hyperthermia. On initial assessment, he was only oriented to person and demonstrated shaking rigors. Lab test results were significant for leukocytosis, with troponins 2.94. A chest X-ray revealed left lower-lobe opacification. He was initially treated for community-acquired pneumonia and his elevated troponin required further work up. He was moved to the Intensive Care Unit (ICU) due to worsening respiratory distress, shaking tremors, and confusion. His troponins remained elevated. On his third day of hospitalization, his rigors had improved, but clonus was present. A medication review revealed the patient was on sertraline. He was started on cyproheptadine. The next morning, his mental status had improved to alert and oriented, and his condition returned to baseline. Upon discharge to a rehab facility, sertraline was discontinued.

CONCLUSIONS: Serotonin syndrome is a condition that is often not initially recognized. Our patient had multiple health problems and presented with altered mental status and tremors, and serotonin syndrome was not recognized until a full neurological exam and medication review had been done. It is important for physicians to be aware of serotonin syndrome as a differential diagnosis, as the symptoms can be masked by other presenting symptoms.

Keywords: Community-Acquired Infections, Myocardial Ischemia, Serotonin Syndrome

0 Comments

SARS-CoV-2/COVID-19

08 December 2021 : Case report  Poland

A 63-Year-Old Man with a Diagnosis of Re-Infection with SARS-CoV-2 Nine Weeks After an Initial Hospital Adm...

Am J Case Rep In Press; DOI: 10.12659/AJCR.932999  

01 December 2021 : Case report  USA

A 48-Year-Old Immunocompetent Female Resident of Southern Florida with Confirmed Reinfection with P.1 (Gamm...

Am J Case Rep In Press; DOI: 10.12659/AJCR.935329  

26 November 2021 : Case report  Poland

Arteritic Anterior Ischemic Optic Neuropathy in the Course of Giant Cell Arteritis After COVID-19

Am J Case Rep In Press; DOI: 10.12659/AJCR.933471  

01 December 2021 : Case report  USA

Progressive Pulmonary Fibrosis After Non-Critical COVID-19: A Case Report

Am J Case Rep 2021; 22:e933458

In Press

08 Dec 2021 : Case report  Poland

A 63-Year-Old Man with a Diagnosis of Re-Infection with SARS-CoV-2 Nine Weeks After an Initial Hospital Adm...

Am J Case Rep In Press; DOI: 10.12659/AJCR.932999  

08 Dec 2021 : Case report  USA

Prolonged Cefepime-Induced Neurotoxicity in a Patient with End-Stage Renal Disease

Am J Case Rep In Press; DOI: 10.12659/AJCR.934083  

07 Dec 2021 : Case report  Greece

Combination of Adenomyoepithelioma and Adenoid Cystic Carcinoma of the Breast: A Case Report of an Uncommon...

Am J Case Rep In Press; DOI: 10.12659/AJCR.934391  

07 Dec 2021 : Case report  Germany

A Rare Cause of Left Shoulder Pain in a Peritoneal Dialysis Patient

Am J Case Rep In Press; DOI: 10.12659/AJCR.933223  

Most Viewed Current Articles

15 Aug 2020 : Case report  USA

A 57-Year-Old African American Man with Severe COVID-19 Pneumonia Who Responded to Supportive Photobiomodul...

DOI :10.12659/AJCR.926779

Am J Case Rep 2020; 21:e926779

09 May 2019 : Case report  USA

A Rare Case of Stage IV Basaloid Squamous Cell Cancer with Intrapulmonary and Brain Metastases

DOI :10.12659/AJCR.915073

Am J Case Rep 2019; 20:664-667

13 Mar 2019 : Case report  USA

Dry Beriberi Due to Thiamine Deficiency Associated with Peripheral Neuropathy and Wernicke’s Encephalopathy...

DOI :10.12659/AJCR.914051

Am J Case Rep 2019; 20:330-334

09 Jan 2019 : Case report  Saudi Arabia

3-M Syndrome: A Local Case Report

DOI :10.12659/AJCR.912736

Am J Case Rep 2019; 20:36-38

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923