title: Salicylate-induced pulmonary edema--a near-miss diagnosis.
abstract: A 43-year-old white woman presented to the emergency department with confusion, agitation, and progressive dyspnea. Chest x-ray revealed pulmonary edema. Initial diagnostic considerations were pneumonia, pulmonary embolism, sepsis, central nervous system infection, substance toxicity, and heart failure. Her salicylate level was 92.6 mg/dL, and an arterial blood gas revealed a respiratory alkalosis and nonanion gap metabolic acidosis, consistent with salicylate poisoning. Noncardiogenic pulmonary edema is an atypical presentation of salicylate toxicity, and this case highlights the importance of an early toxicology screen to make a time-critical diagnosis and provide specific treatment.
authors.affiliation: Department of Internal Medicine Bassett Medical Center, Columbia University, Cooperstown, NY. Electronic address: nataliya.yuklyaeva@bassett.org.
authors.forename: Nataliya
authors.initials: N
authors.lastname: Yuklyaeva
authors.affiliation: Department of Internal Medicine Bassett Medical Center, Columbia University, Cooperstown, NY.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Chaudhary
authors.affiliation: Department of Internal Medicine Bassett Medical Center, Columbia University, Cooperstown, NY.
authors.forename: Ramakrishna
authors.initials: R
authors.lastname: Gorantla
authors.affiliation: Department of Internal Medicine Bassett Medical Center, Columbia University, Cooperstown, NY.
authors.forename: Edward
authors.initials: E
authors.lastname: Bischof
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D011654:Pulmonary Edema / Q000139:chemically induced* / Q000175:diagnosis* / Q000628:therapy*; D012459:Salicylates / Q000506:poisoning*
chemical_list: D012459:Salicylates