An Uncommon Reaction to a Very Common Drug: Hydrochlorothiazide-Induced Pulmonary Edema

Non-cardiogenic pulmonary edema is a rare but serious adverse reaction to hydrochlorothiazide. We present a case report of a patient who developed severe dyspnea and hypoxemic respiratory failure within 30 minutes of the first hydrochlorothiazide dose. Management consisted of supportive care, oxygen therapy, and avoidance of thiazide diuretics, consistent with prior reports. This case emphasizes the importance of recognizing hydrochlorothiazide-induced non-cardiogenic pulmonary edema as a rare but life-threatening adverse event, the limitations of relying solely on biomarkers such as procalcitonin, and the need for careful documentation to prevent re-exposure.