A 38-year-old woman presents to a Melbourne ED, triage category 2, with agitation, diarrhoea and fever after adding tramadol to sertraline. Temp 39.0

Question

A 38-year-old woman presents to a Melbourne ED, triage category 2, with agitation, diarrhoea and fever after adding tramadol to sertraline. Temp 39.0 C, HR 132, BP 168/94. Exam shows inducible ankle clonus, hyperreflexia and tremor. CK is mildly elevated. What is the most likely diagnosis?

Accepted Answer

Serotonin syndrome

Answer

Malignant hyperthermia

Answer

Neuroleptic malignant syndrome

Answer

Anticholinergic poisoning

Answer

Alcohol withdrawal delirium

Serotonin syndrome — ACEM Fellowship MCQ

A 38-year-old woman presents to a Melbourne ED, triage category 2, with agitation, diarrhoea and fever after adding tramadol to sertraline. Temp 39.0 C, HR 132, BP 168/94. Exam shows inducible ankle clonus, hyperreflexia and tremor. CK is mildly elevated. What is the most likely diagnosis?