• Naoyuki Yoshimine, Nobuyuki Oba, Chika Hasegawa, Nanako Inoue, Hideki Nagumo, Makoto Arashiyama, Shinya Orihara, Shintaro Takahashi, Mitsuko Inuyama, and Shuta Nishinakagawa.
• Department of Gastroenterology, Tokyo Rosai Hospital, Japan Organization of Occupational Health and Safety, Japan.
• Intern. Med. 2024 Aug 1; 63 (15): 215721612157-2161.

AbstractA 51-year-old man presented with sudden-onset palpitations and dyspnea that had started 8 h earlier. The patient was restless and tachypneic and had persistent vomiting upon arrival. His sensorium and oxygen saturation levels rapidly declined three hours after arrival, and he was placed on a ventilator. On hospitalization day 2, he was removed from the ventilator and claimed that he had consumed a large amount of energy drinks (oral caffeine intake, approximately 1 g). The theophylline level on arrival had been elevated (9.0 μg/mL). Caffeine intoxication should be considered in patients presenting with restlessness, tachypnea, frequent vomiting, lactic acidosis, and electrolyte abnormalities.

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