Multiple drugs: Cytokine release syndrome and lack of efficacy.

A 65-year-old man with adenocarcinoma of the cardia developed cytokine release syndrome (CRS) while being treated with nivolumab, fluorouracil, and oxaliplatin. He also experienced lack of efficacy with sodium-chloride while being treated for hypotension. The patient presented with fever, shivering, tachycardia, and hypoxemia, and was diagnosed with pulmonary sepsis and possible diffuse interstitial lung disease. He developed additional symptoms including nausea, rash, and acute kidney injury. The patient's symptoms eventually resolved after treatment with methylprednisolone, dexchlorpheniramine, norepinephrine, ceftazidime, vancomycin, and hydrocortisone. It was concluded that the patient experienced nivolumab, fluorouracil, and oxaliplatin-induced CRS, which led to multiple organ failure. [Extracted from the article]