Beyond the obvious: Paediatric methadone toxicity with benzodiazepine co-exposure

Authors

Uzma Siddique, National Institute of Child Health, Karachi, Pakistan
Syed Muhammad Aqeel Abidi, Aga Khan UniversityFollow
Murtaza Ali Gova, National Institute of Child Health, Karachi, Pakistan
Hira Nawaz, National Institute of Child Health, Karachi, Pakistan
Syeda Namayah Fatima Hussain, Liaquat National Hospital and Medical College, Pakistan

Document Type

Article

Department

Medical College Pakistan

Abstract

A previously healthy young male infant presented to the emergency department in a comatose state with clinical signs suggestive of opioid toxicity. Despite early mechanical ventilation and continuous naloxone infusion, neurological improvement was limited. Brain MRI confirmed toxic encephalopathy. Subsequent urine toxicology revealed co-ingestion of methadone and benzodiazepines, prompting the sequential addition of flumazenil, which led to full neurological recovery. This case highlights the critical importance of investigating co-ingestions when response to initial antidote therapy is inadequate, underscores the diagnostic role of neuroimaging in toxic encephalopathy, and emphasises the necessity of safe drug storage practices.

Comments

Pagination is not provided by author/publisher.

AKU Student

no

Publication (Name of Journal)

BMJ Case Reports

DOI

10.1136/bcr-2025-271511

Recommended Citation

Siddique, U., Abidi, S. A., Gova, M. A., Nawaz, H., Hussain, S. F. (2026). Beyond the obvious: Paediatric methadone toxicity with benzodiazepine co-exposure. BMJ Case Reports, 19(1).
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_mc/576