A 64-Year-Old Man With Throat Swelling

Patricia Ayuk Noumedem, PharmD; Marissa Tabile; Ermias Shikur; Bini Mathews; Anthony L. Huynh; Tracy Kwaku

Disclosures

August 08, 2018

Editor's Note:

The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to recognize accurately. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a Case Challenge, please contact us.

Background

A 64-year-old black man is admitted to the emergency department with throat swelling, difficulty swallowing, and drooling (Figure).

Figure 1.

His past medical history is significant for hypertension, diabetes mellitus, substance abuse (heroin), depression, schizophrenia, and alcohol abuse. He also has a past medical history of tongue swelling and airway compromise.

No history of home medications is reported; however, he was alleged to have ingested lisinopril that was prescribed for his mother. Upon admission, he is administered dexamethasone, diphenhydramine, a fentanyl drip, a versed drip, a propofol drip, a phenylephrine drip, amlodipine, carvedilol, hydralazine, albuterol sulfate, dextrose sodium, heparin, famotidine, and acetaminophen, as well as mechanical ventilation.

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