A 27-year-old woman with
schizophrenia showed signs of
neuroleptic malignant syndrome with disturbed consciousness, high
fever,
muscle rigidity, and autonomic dysfunction (including
tachycardia and enhancement of saliva secretion). Since the age of 15, she had been treated at a local psychiatric clinic with a diagnosis of
schizophrenia. On the day she was brought to the emergency room, she was asleep in the morning, but
tachycardia was observed in the evening in the absence of consciousness. The patient was brought to our hospital by ambulance. It was revealed that she had taken a massive dose of
chlorpromazine hydrochloride in the morning on the same day. On arrival, the Japan
coma scale, pulse, respiratory rate, body temperature, and Sp(O2) were 300, 114 beats x min(-1), 26 breaths x min(-1), 39.0 degrees, and 91% (room air), respectively. The CPK level was 1,776 IU x l(-1). Sp(O2), bilateral
pneumonia, and right
atelectasis improved 2 hours after admission. Endotracheal intubation was performed for
artificial respiration. Salivation, marked sweating, and rigidity of the limbs were noted. Under a diagnosis of
neuroleptic malignant syndrome,
dantrolene was administered. For
pneumonia,
ceftriaxone and
pazufloxacin were administered. The consciousness became clear 2 days after admission. The patient was discharged 10 days after admission.