1/3
I saw a very interesting case recently.
22 yo M - previously well - collapsed while running a half marathon.
In ED, found to have rectal Temp 40.2 degrees C and heart rate 160/min. His mental status was altered.
Labs are shown in graphic below.
What's going on?
I saw a very interesting case recently.
22 yo M - previously well - collapsed while running a half marathon.
In ED, found to have rectal Temp 40.2 degrees C and heart rate 160/min. His mental status was altered.
Labs are shown in graphic below.
What's going on?
2/3
The patient had exertional heatstroke, which is defined by core body temperature ≥ 104 F (40 C) with CNS dysfunction, often progressing to multiple organ system failure.
Heatstroke results from thermoregulatory failure + intense activation of inflammation and coagulation.
The patient had exertional heatstroke, which is defined by core body temperature ≥ 104 F (40 C) with CNS dysfunction, often progressing to multiple organ system failure.
Heatstroke results from thermoregulatory failure + intense activation of inflammation and coagulation.
3/3
Guidelines recommend using a scoring system to diagnose DIC (see graphic).
However, in this case the score did not meet the threshold for diagnosis.
This is an example where clinical gestalt rules the day. The patient had classic heatstroke-associated DIC!
Guidelines recommend using a scoring system to diagnose DIC (see graphic).
However, in this case the score did not meet the threshold for diagnosis.
This is an example where clinical gestalt rules the day. The patient had classic heatstroke-associated DIC!
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