A 38-year-old man with schizophrenia presents with fever, confusion, and altered mental status 3 days after initiating high-dose haloperidol. Vital signs show temperature 39.2°C, heart rate 118/min, blood pressure 152/94 mmHg, and respiratory rate 22/min. Physical examination demonstrates lead-pipe rigidity and diaphoresis. Laboratory studies reveal creatine kinase 2,840 U/L and normal liver function tests. Which of the following is the most likely diagnosis?
- A)Neuroleptic malignant syndromeGABARITO
- B)Malignant hyperthermia
- C)Serotonin syndrome
- D)Lithium toxicity
- E)Anticholinergic toxicity
Explicação
Neuroleptic malignant syndrome is a life threatening reaction to dopamine antagonists and features hyperthermia, altered mental status, lead-pipe rigidity, and elevated CK from muscle breakdown. The timing after haloperidol initiation is classic. Ver explicação completa e trilha adaptativa →