Floral phantosmia and bradycardia: A unique case of digoxin toxicity in an elderly patient
Marsida Kasa1
, Brunilda Elezi2, Eglantina Sinamati3, Nereida Spahia4, Merita Rroji4
1Department of Internal Medicine, University Hospital of Trauma, Albani
2Faculty of Technical Medical Sciences, University of Elbasan “Aleksander-Xhuvani”, Elbasan, Albania
3Health Center Kamez, Faculty of Medicine, University of Medicine Tirana, Albania
4Department of Nephrology, Faculty of Medicine, University of Medicine Tirana, Albania
Keywords: Digoxin intoxication, drug interactions, older patients, phantosmia, renal failure
Abstract
This case report presents a rare clinical manifestation of digoxin toxicity in a 73 year old female with acute kidney injury, bradycardia, and unique sensory disturbances, including phantosmia (floral scent hallucinations) and photopsia (seeing sparkles of light). The patient, with a history of hypertension and atrial fibrillation, had been on digoxin for 2 weeks, raising concerns about possible digoxin intoxication. Upon admission, bradycardia, hypokalemia, and elevated serum digoxin levels confirmed toxicity. The patient’s olfactory and visual hallucinations, rare symptoms in such cases, gradually resolved after stopping digoxin. This case emphasizes the importance of recognizing subtle and unusual symptoms, like changes in smell and vision, which can enhance early detection, especially in older patients, leading to quicker interventions and better patient outcomes.
How to cite this article: Kasa M, Elezi B, Sinamati E, Spahia N, Rroji M. Floral phantosmia and bradycardia: A unique case of digoxin toxicity in an elderly patient. Turk J Emerg Med 2025;25:317-20.
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that her name and initials will not be published and due efforts will be made to conceal her identity, but anonymity cannot be guaranteed.
Following the case MK (lead) and ES (supporting); conceptualization MK and MRr (lead); review the literature MK, MRr, ES, BE, and NS (equal); writing the manuscript MK, MRr, NS (supporting) and BE (equal); review the manuscript and editing the final version MR, BE (equal). Marsida Kasa and Merita Rroji contributed equally as the first author in the manuscript.
None declared.
None.