Case 9-2011 — A 37-Year-Old Man with Flushing and Hypotension  

Oleh:

Murali, Mandakolathur R. ; Castells, Mariana C. ; Song, James Y. ; Dudzinski, David M.

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 364 no. 12 (Mar. 2011), page 1155-1165.
Topik: Fever; Weakness

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2011.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Presentation of Case Dr. Leana S. Wen (Emergency Medicine): A 37-year-old man was admitted to the hospital because of flushing and hypotension. That morning, sneezing, rhinorrhea, scratchy throat, and subjective fever had developed. After lunch, he took an over-the-counter cold preparation that included acetylsalicylic acid, dextromethorphan hydrobromide, and phenylephrine bitartrate. Thirty minutes later, fatigue, weakness, nausea, epigastric pain, facial flushing, and “beefy red” ears developed, accompanied by two episodes of nonbloody emesis. Light-headedness, diaphoresis, and near-syncope developed. He was caught by a coworker as he fell to the ground, without head trauma or loss of consciousness. Emergency medical services were called. On evaluation, his skin was flushed; the systolic blood pressure was 50 mm Hg, the pulse 56 beats per minute and regular, the respiratory rate 16 breaths per minute, and the oxygen saturation 100% while he was breathing supplemental oxygen by means of a nonrebreather face mask. An electrocardiogram (ECG) showed sinus bradycardia with T-wave inversions. Ondansetron and normal saline were administered intravenously. He was transported to the emergency department at this hospital.

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