A case study of delayed serotonin syndrome: lessons learned.

Serotonin syndrome is a potentially life-threatening condition that results from excessive serotonin agonism of the central and peripheral nervous system. Though serotonin syndrome is most often associated with ingestion of more than one serotonergic drug, many other mechanisms have been associated with serotonergic excess. This case study presents a 79-year-old African-American female, an assisted living resident, who presented to the emergency department with altered mental status, acute onset of "chills," reduced appetite, urinary incontinence, and an elevated temperature of 103 degrees F (39.