Unexpected amantadine intoxication in the death of a trauma patient

We present a case of amantadine intoxication that developed unexpectedly in a hospitalized patient with craniocerebral trauma. The intoxication confused the clinical situation and contributed to the patient's deterioration and death. After excluding overdosage as the cause of the intoxication, we concluded that the excessive blood drug levels (39 mg/L) resulted from tubulointerstitial nephritis--induced renal failure. This case represents an example of an adverse drug reaction that resulted in an unusual drug intoxication and illustrates why toxicological analyses are important for investigation of deaths in hospitalized patients.