Acute Cocaine Intoxication Leading to Multiorgan Dysfunction: A Case Report on Concealed Cocaine Use

Dr. Nafeesath PCP, Dr. S P Rai, Dr. Sunny Aachwani

Abstract: Introduction: Cocaine abuse remains a significant global public health concern due to its widespread recreational use. It continues to pose substantial diagnostic challenges because of its unpredictable pharmacologic effects, potential for multisystem involvement, and the frequent concealment of usage by patients. Case Report: This case outlines the clinical course of a middle-aged female patient who, following travel to a high-altitude location, presented with fever, cough, dyspnea, and altered mental status. On evaluation she had multiorgan dysfunction?including transaminitis, bicytopenia, acute kidney injury, bilateral lung consolidation, gastrointestinal bleeding, altered sensorium, and mononeuropathy. The initial clinical suspicion was sepsis with multiorgan failure secondary to community acquired pneumonia, as both the patient and her family denied any substance abuse. After ruling out infectious and autoimmune causes, suspicion of cocaine toxicity was raised due to the presence of hyperthermia, accelerated hypertension, mydriasis, and clinical signs indicative of systemic vasoconstriction. A urine toxicology test was strongly positive for cocaine. The patient was managed in the intensive care unit, where she received a combination of antibiotics, steroids, nitroglycerin infusion, hemodialysis, multiple blood product transfusions, and intensive neuropsychiatric rehabilitation. Over the course of four weeks, she demonstrated significant clinical improvement and ultimately returned to her baseline functional status. Conclusion: This case report offers valuable prognostic insight into the importance of suspecting cocaine abuse in patients presenting with altered mental status, multiorgan failure, and signs of systemic vasoconstriction.

Keywords: cocaine, intoxication, drug abuse, multiorgan dysfunction

How to Cite?: Dr. Nafeesath PCP, Dr. S P Rai, Dr. Sunny Aachwani, "Acute Cocaine Intoxication Leading to Multiorgan Dysfunction: A Case Report on Concealed Cocaine Use", Volume 14 Issue 11, November 2025, International Journal of Science and Research (IJSR), Pages: 1653-1657, https://www.ijsr.net/getabstract.php?paperid=MR251124120748, DOI: https://dx.doi.org/10.21275/MR251124120748