Introduction: A rare and atypical form of Neuroleptic Malignant Syndrome (NMS) can be a deceptive and life threatening condition if not diagnosed properly in acute and critical care settings. Methods: The management o...Introduction: A rare and atypical form of Neuroleptic Malignant Syndrome (NMS) can be a deceptive and life threatening condition if not diagnosed properly in acute and critical care settings. Methods: The management of a patient presenting with atypical NMS without prominent rigidity, but with extensive rhabdomyolysis after the administration of haloperidol and ziprasidone is described in this report. Results: Prompt recognition of atypical features of NMS was managed by intensive care unit admission, supportive care and pharmacotherapy, leading to a complete resolution of the syndrome and a favorable outcome verified by laboratory findings. Conclusion: Early stages and atypical features of NMS may be variable in presentation and clinical course. The absence of muscle rigidity may not rule out NMS. A strong clinical suspicion based on clinical history is crucial for early diagnosis and treatment. Termination of dantrolene therapy may not be necessary during rhabdomyolysis and elevated aminotransferase levels.展开更多
Introduction: Status asthmaticus is an acute exacerbation of asthma caused by increased airflow resistance and mucus plugging. Symptoms of dyspnea may lead to respiratory failure and cardiac arrest. There is limited k...Introduction: Status asthmaticus is an acute exacerbation of asthma caused by increased airflow resistance and mucus plugging. Symptoms of dyspnea may lead to respiratory failure and cardiac arrest. There is limited knowledge about the effects of marijuana on pulmonary function. We report a unique case of status asthmaticus related to frequent marijuana use. Case Presentation: A 38-year-old African American male with a past medical history of asthma and two prior episodes of status asthmaticus arrived at Saint Barnabas Medical Center with dyspnea and wheezing that was refractory to home albuterol nebulizer therapy. Despite medical treatment his symptoms did not improve and he collapsed to the floor and required intubation and mechanical ventilation. He reported having smoked marijuana numerous times on the day prior to this admission. He was discharged three days later and was strongly advised to stop smoking marijuana. Conclusion: Marijuana is a commonly smoked illicit drug. Although habitual marijuana smokers have symptoms of cough, phlegm and wheezing, we found no reports linking marijuana use to the development of status asthmaticus. Given the rampant abuse of marijuana and its likely burden on healthcare, physicians should be vigilant in discussing the harmful effects of marijuana with asthmatic patients who abuse this drug.展开更多
文摘Introduction: A rare and atypical form of Neuroleptic Malignant Syndrome (NMS) can be a deceptive and life threatening condition if not diagnosed properly in acute and critical care settings. Methods: The management of a patient presenting with atypical NMS without prominent rigidity, but with extensive rhabdomyolysis after the administration of haloperidol and ziprasidone is described in this report. Results: Prompt recognition of atypical features of NMS was managed by intensive care unit admission, supportive care and pharmacotherapy, leading to a complete resolution of the syndrome and a favorable outcome verified by laboratory findings. Conclusion: Early stages and atypical features of NMS may be variable in presentation and clinical course. The absence of muscle rigidity may not rule out NMS. A strong clinical suspicion based on clinical history is crucial for early diagnosis and treatment. Termination of dantrolene therapy may not be necessary during rhabdomyolysis and elevated aminotransferase levels.
文摘Introduction: Status asthmaticus is an acute exacerbation of asthma caused by increased airflow resistance and mucus plugging. Symptoms of dyspnea may lead to respiratory failure and cardiac arrest. There is limited knowledge about the effects of marijuana on pulmonary function. We report a unique case of status asthmaticus related to frequent marijuana use. Case Presentation: A 38-year-old African American male with a past medical history of asthma and two prior episodes of status asthmaticus arrived at Saint Barnabas Medical Center with dyspnea and wheezing that was refractory to home albuterol nebulizer therapy. Despite medical treatment his symptoms did not improve and he collapsed to the floor and required intubation and mechanical ventilation. He reported having smoked marijuana numerous times on the day prior to this admission. He was discharged three days later and was strongly advised to stop smoking marijuana. Conclusion: Marijuana is a commonly smoked illicit drug. Although habitual marijuana smokers have symptoms of cough, phlegm and wheezing, we found no reports linking marijuana use to the development of status asthmaticus. Given the rampant abuse of marijuana and its likely burden on healthcare, physicians should be vigilant in discussing the harmful effects of marijuana with asthmatic patients who abuse this drug.
