OWN - NLM
DA - 20170304
LR - 20170313
IS - 1757-790X (Electronic)
IS - 1757-790X (Linking)
VI - 2017
DP - 2017 Mar 03
TI - Rare case of severe serotonin syndrome leading to bilateral compartment syndrome.
LID - bcr2016218842 [pii]
LID - 10.1136/bcr-2016-218842 [doi]
AB - The term 'serotonin syndrome' describes a constellation of symptoms caused by
serotonergic overstimulation. Its characteristic clinical presentation consists
of encephalopathy, neuromuscular signs and autonomic hyperactivity. After removal
of the offending agent, the clinical course is usually self-limited but can
occasionally lead to severe symptoms. We report the case of a 68-year-old woman
who presented emergently with encephalopathy. Home medications included
paroxetine and dextroamphetamine/amphetamine. Physical examination revealed
tachycardia, tachypnoea, diaphoresis, rigidity, hyperreflexia and clonus. Given
the fast onset of symptoms, a diagnosis of serotonin syndrome was made.
Laboratory studies showed acute-on-chronic kidney injury and elevated creatine
kinase. The patient's mental status quickly returned to baseline with supportive
care. Her rhabdomyolysis, however, persisted and led to acute compartment
syndrome in her lower extremities. After bilateral leg fasciotomies and treatment
of a severe wound infection with intravenous antibiotics, the patient has now
recovered with complete resolution of her symptoms.
CI - 2017 BMJ Publishing Group Ltd.
FAU - Clarissa Samara, Verena
AU - Clarissa Samara V
AD - Department of Neurology, University of Utah, Salt Lake City, Utah, USA.
FAU - Warner, Judith
AU - Warner J
AD - University of Utah, Salt Lake City, Utah, USA.
AD - Department of Ophthalmology and Visual Sciences, University of Utah, Salt Lake
City, Utah, USA.
LA - eng
PT - Case Reports
PT - Journal Article
DEP - 20170303
PL - England
TA - BMJ Case Rep
JT - BMJ case reports
JID - 101526291
SB - IM
MH - Aged
MH - Compartment Syndromes/*etiology/*surgery
MH - Fasciotomy/adverse effects/methods
MH - Female
MH - Humans
MH - Leg/pathology/surgery
MH - Serotonin Syndrome/*complications
MH - Surgical Wound Infection/drug therapy
MH - Treatment Outcome
EDAT- 2017/03/05 06:00
MHDA- 2017/03/14 06:00
CRDT- 2017/03/05 06:00
AID - bcr-2016-218842 [pii]
AID - 10.1136/bcr-2016-218842 [doi]
PST - epublish
SO - BMJ Case Rep. 2017 Mar 3;2017. pii: bcr2016218842. doi: 10.1136/bcr-2016-218842.