Serotonin syndrome: a rare undiagnosed cause of hyperpyrexia

Abstract

Serotonin syndrome (SS) is a rare but potentially life-threatening condition, and it is caused byincreasing serotonergic activities. It is an underdiagnosed and under-reportedcondition. Clinical manifestations can range from mild to moderate to severesymptoms. The intensity of symptoms reflects the degree of serotonin toxicity, andmild serotonin syndrome is easily overlooked by physicians.Severe serotonintoxicity typically occurs to a combination of serotonergic agents.Herein, we describe acase of severe serotonin toxicity in a 38-year-old Egyptian male with a historyof generalized anxiety disorder and depression. With increased depressivesymptoms, he received 20 mg of fluoxetine daily, and the symptomsdeveloped 1 month after starting fluoxetine, which is the uncommon onsetof presentation. The patient was already on tramadol for chronic low backache. Theaim is to increase awareness of the syndrome among physicians andneuropsychiatrists.