Zeitschrift für klinische Toxikologie
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Case Report: A Case of Methotrexate Intoxication Presenting as a Pseudo-Disseminated Herpes Zoster Infection

Mathieu Boudreau-Frenette and Gabriel Girouard

Background: Oral Methotrexate (MTX) intoxication is an uncommon, but potentially fatal situation.

Case presentation: We report the case of a 55-year-old woman who suffered from an inadvertent MTX intoxication caused by erroneous daily ingestion. She presented with recurrent bouts of febrile pancytopenia with associated skin lesions suspected initially to be a disseminated herpes zoster infection. Multiple negative Herpes Simplex (HSV) and Varicella-Zoster Virus (VZV) PCR testing along with a confirmed medication misusage established our diagnosis.

Conclusion: This case illustrates the importance of early recognition of MTX toxicity, which can have potentially devastating consequences. Healthcare providers need to be informed about the diverse clinical presentations of MTX intoxication and maintain a high degree of clinical suspicion with any patients exposed to this drug.