Open AccessRefractory status epilepticus, circulatory collapse after cardiac arrest, and acute respiratory distress syndrome caused by severe isolated fluvoxamine poisoning: a case report
Author(s) -
Kan'o Tomomichi,
Kamijo Yoshihito,
Hattori Jun,
Kashimi Fumie,
Sato Chie,
Yoshimura Kuniko
Publication year - 2015
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.53
Subject(s) - extracorporeal membrane oxygenation , medicine , anesthesia , status epilepticus , circulatory collapse , fluvoxamine , circulatory system , propofol , respiratory distress , epilepsy , receptor , psychiatry , serotonin , fluoxetine
Case A 30‐year‐old female ingested 21.75 g fluvoxamine in a suicide attempt. She presented with grand mal seizures and vomiting on admission to our E mergency C enter, with a fluvoxamine serum concentration of 4.58 μg/ mL . The patient was diagnosed with status epilepticus, which could not be fully suppressed with the maximum dosage of benzodiazepines. The patient also developed circulatory collapse after resuscitation for sudden cardiac arrest and acute respiratory distress syndrome, believed to be secondary to aspiration. Outcome With venoarterial extracorporeal membrane oxygenation, a massive infusion of propofol successfully suppressed status epilepticus, and both the circulatory collapse and acute respiratory distress syndrome gradually improved; venoarterial extracorporeal membrane oxygenation and propofol treatments were then terminated, and the patient was discharged without further disabilities. Conclusion Compared to all other reported clinical cases of fluvoxamine poisoning, the patient in this study ingested the highest dose and developed the most severe symptoms, but was successfully treated without any disabilities.