Salicylate-induced pulmonary edema--a near-miss diagnosis

Am J Emerg Med. 2014 May;32(5):490.e5-6. doi: 10.1016/j.ajem.2013.11.021. Epub 2013 Nov 22.


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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Diagnosis, Differential
  • Female
  • Humans
  • Pulmonary Edema / chemically induced*
  • Pulmonary Edema / diagnosis*
  • Pulmonary Edema / therapy*
  • Salicylates / poisoning*


  • Salicylates