A 58-Year-Old Woman With An Unusual Cause Of Respiratory Failure

Abstract

A 58-year-old woman presented to the emergency department (ED) after she was found unresponsive for an unknown period of time. Upon paramedics’ arrival she had a respiratory rate of 4 breaths/min, an O2 saturation of 71% and a Glasgow Coma Score of 3. Her home medications included ibuprofen, fentanyl and lorazepam. The patient’s mental status deteriorated and she ultimately required intubation and mechanical ventilation. She was managed in the intensive care unit (ICU) for what appeared to be a drug overdose and on the following day, after successful extubation, was transferred to the medicine wards. We report an unexpected twist in the pathogenesis of this case.