Acute pulmonary edema induced by non-ionic low-osmolar radiographic contrast media

BACKGROUND: Non-cardiogenic pulmonary edema (NCPE) after intravenous (iv) administration of non-ionic radiocontrast media (RCM) is a rare but life-threatening complication. In a context of emergency, its diagnosis is difficult. CASE REPORT: We report the case of a 55-year-old woman who developed an acute pulmonary edema following iv infusion of non-ionic, low-osmolar RCM during abdominal CT scan. She needed a 24-hour hospitalization in intensive care unit for an acute hypoxemic dyspnea. She was falsely treated at first for an anaphylactic reaction, and then for a cardiac failure. She improved with cortisone and diuretic treatment. CONCLUSION: Although NCPE has been rarely reported after RCM injection, it remains an acute severe complication that has to be considered. The differential diagnosis involves multiple pathogenic patterns giving furthermore complexity in choosing an appropriate treatment.