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Nightmares also categorized as fighting dreams suddenly awake the sleeper from Rapid Eye Movement (REM) sleep. Nightmares can be caused by improper food intake, alcohol withdrawal, digestive or nervous disorders and drug induced (mainly due to the drugs which affect the neurotransmitters). Some of the drugs that can induce nightmares are Beta blockers, Statins, Anti depressants, Anti epileptics, Sedative hypnotics, General anesthetic agents, anti histamines, endocrinal agents etc., The exact mechanisms involved for these drug induced nightmares is not clear. The occurrence of these nightmares due to the intake of various drugs is rare and in all these cases drug withdrawal is beneficial.

Pulmonary tuberculosis (PTB) can lead to acute respiratory distress syndrome (ARDS), which can be at times fatal. Venovenous extracorporeal membrane oxygenation (VV-ECMO) ensures adequate oxygenation and carbon dioxide removal, avoiding ventilator-induced lung injury. We present a case where a young woman with refractory respiratory failure caused by PTB, unresponsive to conventional mechanical ventilation, but was successfully managed with prolonged VV-ECMO support. The patient diagnosed with PTB was started on antitubercular treatment but went into respiratory failure and ARDS. The patient was put on mechanical ventilation, on which she was not improving. The patient was then put on ECMO. On the 9 th day, lung compliance and gas exchange were good enough to resume conventional mechanical ventilation. ECMO was weaned and removed. This is one of few cases of survival of the patient with PTB with ARDS utilizing ECMO.