Hyperthermia and rigidity following overdose of an unknown drug; a case report and literature review

Drug induced hyperthermia is a rare presentation which can rapidly lead to gross metabolic abnormality and death. These presentations are further complicated by the wide range of potentially causative agents. We present a case of rigidity and hyperthermia, following overdose of an initially unknown substance leading to challenging management decisions in the Emergency Department. This case was later identified as Serotonin Syndrome. The patient presented with trismus which was managed with rapid sequence induction of anaesthesia to allow airway protection. On extubation a significant degree of laryngeal oedema complicated weaning, a possible complication of Serotonin Syndrome not previously described in the literature. We discuss the pathophysiology of Serotonin Syndrome, important differentials and practical considerations in managing hypertonicity of unknown origin in a young person

Migrating ingested foreign body of the upper aerodigestive tract with resultant septic shock: case report and literature review

Complications due to foreign body ingestion are rare; however, if present, these can cause significant morbidity to the patient. An overlooked ingested foreign body could present as an emergency and may prove fatal. We present a case of an accidentally ingested foreign body with delayed presentation, which migrated to the neck and produced a cervical abscess presenting as septic shock. The patient required prompt stabilisation followed by surgical intervention. The patient's vital signs returned to normal on the second post-operative day, and he was discharged the following day