Acute Water Intoxication Leading to Dilutional Hyponatremia in a Patient With Urinary Tract Infection: A Case Report

Acute water intoxication is an uncommon but potentially fatal condition characterized by excessive water consumption over a brief period. It results in dilutional hyponatremia. The condition is frequently associated with psychiatric disorders, endurance athletics, or iatrogenic causes. Early recognition and prompt treatment are crucial for preventing serious complications and ensuring favorable outcomes. A 38-year-old male patient presented to the emergency department exhibiting sudden loss of consciousness followed by altered mental status, confusion, and an episode of seizure. The history revealed ingestion of approximately 8 liters of water within a three-hour period while waiting for uroflowmetry testing. Initial laboratory tests indicated severe hyponatremia with serum sodium of 120 mEq/L. He was diagnosed with acute water intoxication with dilutional hyponatremia. Management involved fluid restriction, electrolyte monitoring, and gradual correction of sodium levels utilizing 3% hypertonic saline. The patient's neurological status improved progressively, and he was discharged after five days. This case highlights the significance of identifying acute water intoxication as a potential etiology of dilutional hyponatremia, particularly in patients presenting with neurological symptoms and a history of excessive fluid intake. Expeditious diagnosis and appropriate management are essential to prevent severe complications such as cerebral edema and permanent neurological damage.