{
  "abstract": "A previously healthy young male infant presented to the emergency department in a comatose state with clinical signs suggestive of opioid toxicity. Despite early mechanical ventilation and continuous naloxone infusion, neurological improvement was limited. Brain MRI confirmed toxic encephalopathy. Subsequent urine toxicology revealed co-ingestion of methadone and benzodiazepines, prompting the sequential addition of flumazenil, which led to full neurological recovery. This case highlights the critical importance of investigating co-ingestions when response to initial antidote therapy is inadequate, underscores the diagnostic role of neuroimaging in toxic encephalopathy, and emphasises the necessity of safe drug storage practices.",
  "authors": [
    {
      "affiliations": [
        "Department of Pediatric Intensive Care Unit, National Institute of Child Health, Karachi, Sindh, Pakistan"
      ],
      "name": "Uzma Siddique"
    },
    {
      "affiliations": [
        "PGME, The Aga Khan University Medical College Pakistan, Karachi, Sindh, Pakistan"
      ],
      "name": "Syed Muhammad Aqeel Abidi"
    },
    {
      "affiliations": [
        "Liaquat National Hospital and Medical College, Karachi, Pakistan"
      ],
      "name": "Syeda Namayah Fatima Hussain"
    },
    {
      "affiliations": [
        "Department of Pediatric Intensive Care Unit, National Institute of Child Health, Karachi, Sindh, Pakistan"
      ],
      "name": "Hira Nawaz"
    },
    {
      "affiliations": [
        "Department of Pediatric Intensive Care Unit, National Institute of Child Health, Karachi, Sindh, Pakistan"
      ],
      "name": "Murtaza Ali Gova"
    }
  ],
  "title": "Beyond the obvious: paediatric methadone toxicity with benzodiazepine co-exposure",
  "uid": "762e2255-9f74-5ec3-96b4-22f73e3cf682"
}