A 31-year-old male patient with a history of depression presented with upper gastrointestinal bleeding 72 h after ingestion of 30 mL of medication for suicidal intent (138 mg/kg).
He was admitted consciously, Glasgow 15, with stable hemodynamics and affliction.
Physical examination revealed oral and pharyngeal ulcers.
At the admission laboratory, acute kidney injury (creatinine: 9.58 mg/dL, BUN: 95 mg/dL) and liver injury (total bilirubin: 6.3 140 mg/dL, TU: 3 TG:
Chest computed tomography (CT) showed focal pulmonary condensation compatible with left basal pneumonia, with no signs of esophageal perforation.
Parenteral hydration, hemodialysis, empirical antibiotics (ceftriaxone) were initiated and admitted to the intensive care unit.
Delayed upper digestive endoscopy (day 4 hospitalization) showed grade 2 panofagitis.
She was hospitalized until the sixth day, presenting with rapidly progressive severe respiratory failure with images compatible with acute pulmonary fibrosis.
She was hospitalized with cyclophosphamide, which failed a methylprednisolone protocol 1 g/day for 3 days, 1 g/day IV for 2 days, and N-acetylcysteine to modulate oxidative stress damage.
