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Background
We decided to write the case to report fluoxetine-induced oesophagitis, which has not been reported so far in the literature. This case highlights the importance of a proper technique of swallowing medications to avoid complications, like corrosive injury of oesophagus, and the correct administration of medication, which does not end with writing a prescription but rather entails explaining how (and when) to take a medication.
Case presentation
A 24-year-old man presented to the emergency department at 22:00 with severe retrosternal pain of 2 h duration. The patient had gone asleep after swallowing a capsule of fluoxetine 20 mg, available as an on-the-counter prescription, for premature ejaculation. On further questioning, the patient acknowledged taking little water with capsule and going recumbent immediately. The patient woke up with severe pain and could not swallow water and refused solids because of chest pain. Patient was stable haemodynamically and had normal baseline investigations including complete blood counts and chest radiograph. Electrocardiograph was normal. Patient took a few bananas and was discharged with reassurance.
Next morning, the patient reported with painful swallowing and dysphagia. The patient was taken for oesophagogastroduodenoscopy, which showed three fourths of the lumen of the oesophagus ulcerated with denuded mucosa at 22 cm from the incisors ( figure 1 ). Intravenous pantoprozol and chewable sucralfate was started in addition to intravenous fluids. The patient improved and was able to swallow liquids and discharged from hospital on sucralfate 1 g 4 hourly. On follow-up after 2 weeks, the patient was able...