Adult respiratory distress syndrome induced by salicylate toxicity.

Noncardiogenic pulmonary edema induced by salicylate toxicity is becoming a well-recognized entity. However, the diagnosis can be easily missed early in the disease course. We report here adult respiratory distress syndrome (ARDS) in a 54-year-old man found to have salicylate toxicity one day after admission to the alcohol detoxification service at a community hospital. He had been taking one enteric-coated aspirin tablet twice a day for more than one year. He also had a 40 pack-year history of cigarette smoking. The list in any standard medical text of factors triggering ARDS is quite lengthy. Over the past few years, salicylate toxicity has been added to this list. As the case reported here illustrates, it is most important that salicylate toxicity be considered in the differential diagnosis for any patient with acute onset of pulmonary edema and normal cardiac function.