23 October 2020: Articles
Amiodarone Toxicity Presenting with Acute Onset of Systemic Inflammatory Response Syndrome and Multiorgan Failure Mimicking Sepsis
Unusual clinical course, Challenging differential diagnosis, Unusual or unexpected effect of treatment, Adverse events of drug therapy, Rare coexistence of disease or pathology
Irfanali R. Kugasia A* , Mohsin Ijaz C , Ahsan Khan B , Yashwanth Jasti FDOI: 10.12659/AJCR.926929
Am J Case Rep 2020; 21:e926929
Table 4. Differential diagnoses considered as the possible cause of patient’s clinical symptoms and tests done to rule them out.
| Sr. No. | Differential diagnoses | Tests done to rule it out |
|---|---|---|
| 1. | Infectious etiology | Negative results from: Multiple blood cultures Sputum cultures Respiratory multiplex RT-PCR from nasal swab. Broncho-alveolar lavage tested for: bacterial culture and sensitivity, fungal smear and culture, AFB smear and culture, legionella culture, Nocardia cultures, respiratory multiplex RT-PCR. SARS CoV2 PCR nasal swab CT chest, abdomen and pelvis negative for any infectious etiology |
| 2. | Hyperthyroidism | Normal TSH, T3, T4, no exogenous ingestion of thyroid hormone |
| 3. | TTP/HUS | Normal peripheral smear, haptoglobin level and LDH level |
| 4. | Lymphoma | Flow cytometry from needle aspiration of mediastinal lymph node |
| 5. | Piperacillin/Tazobactam Drug fever | Discordant timeframe of symptom onset. Symptoms present prior to starting of the medications, persistent even after its discontinuation |
| 6. | OTC Drug interaction | None per history |
| 7. | Malignancy | Negative on lung biopsy |