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Hiccups, medically referred as singultus, is a condition that results from involuntary contraction of the diaphragm and intercostal muscles. Singultus is usually a self-limiting condition which typically lasts less than 48 hours but in rare cases, can persist greater than 48 hours. This is a case of a 48 year-old male who was prescribed dexamethasone for COVID-19 but developed intractable singultus for two weeks. Patient was unable to tolerate diet due to intractable singultus leading to vomiting. He underwent various non-pharmacological maneuvers and pharmacotherapy without resolution. Dexamethasone- induced hiccups have been reported as an under recognized side effect of dexamethasone. Despite discontinuation of offending agent, patient’s singultus persisted. The patient achieved resolution of singultus with a combination of baclofen and olanzapine. This case provides additional literature during this COVID-19 pandemic while dexamethasone is being used as the first line management.
Lee YW, Psomiadis J, Akbani S, Lopez-Medal M, Miller A. “Hiccups” with COVID-19 Management. Advances in Clinical Medical Research and Healthcare Delivery. 2022; 2(1). doi: 10.53785/2769-2779.1083.