A 21-Year-Old College Student Is Brought to the Emergency Department

A 21-year-old college student is brought to the emergency department by ambulance.  The patient's friends saw him swallow an unknown substance at a concert party.  Soon afterward, he appeared to be interacting with others at the party.  A few hours later, however, the patient seemed disoriented, appeared flushed, and was sweating profusely.  When emergency responders arrived, they found him having a seizure.  He was stabilized en route to the emergency department, where his seizure stopped.  The patient has no active illnesses except for a history of depression, for which he takes a selective serotonin reuptake inhibitor.  He takes no other medications.  Temperature is 40 C (104 F) , blood pressure is 170/96 mm Hg, pulse is 120/min, and respirations are 18/min.  On examination, the patient is flushed, diaphoretic, and hyperreflexive with occasional myoclonus, and he continues to be disoriented.  Laboratory results are unremarkable except for a serum sodium level of 121 mEq/L.  Which of the following substances is the most likely cause of this patient's condition?

A) Barbiturates
B) Bath salts
C) Benzodiazepines
D) Cocaine
E) Ecstasy
F) Inhalants

Correct Answer:

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