Jornal de Toxicologia Clínica
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Methadone Toxicity: A Pediatric Case Report

Rachel S. Segal, Derek J. Zhorne

Pediatric morbidity and mortality from methadone toxicity has increased in recent years. Multiple publications serve to highlight the danger of methadone ingestion for pediatric patients as there is notable overlap between toxic and fatal levels of methadone for children. This case report presents a 4-year-old male who was admitted to the pediatric intensive care unit due to emesis, altered mental status and acute hypoxemic respiratory failure. Methadone was identified on serum drug screening and no alternative explanation for patient’s clinical presentation was found. This case report highlights importance of additional drug testing and consideration of methadone toxicity whenever a patient presents with miosis, central nervous system depression and respiratory depression as it may require testing beyond the standard urine drug screen to identify the correct drug exposure.