다발성 장기 기능이상과 전격성 폐렴을 동반한 운동유발성 열사병 증례 1례 (Exertional Heat Stroke in a Young Man with Multi-organ Dysfunction and Fulminant Pneumonia)

서지정보

· 발행기관 : 대한응급의학회
· 수록지 정보 : 대한응급의학회지 / 20권 / 4호 / 458 ~ 462페이지
· 저자명 : 최욱진, 이재욱, 이세원

초록

Heat stroke is defined as a core body temperature that rises
above 40C accompanied by central nervous system
abnormalities such delirium, convulsions or coma. Despite
treatment with optimal cooling, heat stroke causes deaths
by complications including rhabdomyolysis, renal failure,
hepatic dysfunction, disseminated intravascular coagulation
syndrome, acute respiratory distress syndrome, bowel
ischemia, myocardial injury, and multiple organ failure. In
some cases of survival, heat stroke it can cause irreversible
CNS damage. Therefore, if exertional heat stroke is properly
diagnosed in the emergency room, we must initiate early
and aggressive treatment in order to prevent the multiorgan
failure and high mortality associated with this condition.
To our knowledge, case reports in the literature are
rare describing that patients with multiple organ dysfunction
and fulminant pneumonia following exertional heat stroke.
This study reports on a relevant case, as well as findings
from the literature. The case history is presented of a 20-
year-old man who presented with exertional heat stroke
with sustained hyperpyrexia ongoing after the first day of
admission despite optimal treatment including intensive
fluid resuscitation. On the 3rd day of admission, chest infiltrated
lesions were discovered. From the high-resolution
computed tomography results, multifocal consolidations
were discovered in both lungs. Blood cultures revealed
Staphylococcus hominis. Treatment with proper antibiotics
was begun after identifying the blood culture. The patient
fully recovered and was discharged on the 10th day after
admission.

영어초록

Heat stroke is defined as a core body temperature that rises
above 40C accompanied by central nervous system
abnormalities such delirium, convulsions or coma. Despite
treatment with optimal cooling, heat stroke causes deaths
by complications including rhabdomyolysis, renal failure,
hepatic dysfunction, disseminated intravascular coagulation
syndrome, acute respiratory distress syndrome, bowel
ischemia, myocardial injury, and multiple organ failure. In
some cases of survival, heat stroke it can cause irreversible
CNS damage. Therefore, if exertional heat stroke is properly
diagnosed in the emergency room, we must initiate early
and aggressive treatment in order to prevent the multiorgan
failure and high mortality associated with this condition.
To our knowledge, case reports in the literature are
rare describing that patients with multiple organ dysfunction
and fulminant pneumonia following exertional heat stroke.
This study reports on a relevant case, as well as findings
from the literature. The case history is presented of a 20-
year-old man who presented with exertional heat stroke
with sustained hyperpyrexia ongoing after the first day of
admission despite optimal treatment including intensive
fluid resuscitation. On the 3rd day of admission, chest infiltrated
lesions were discovered. From the high-resolution
computed tomography results, multifocal consolidations
were discovered in both lungs. Blood cultures revealed
Staphylococcus hominis. Treatment with proper antibiotics
was begun after identifying the blood culture. The patient
fully recovered and was discharged on the 10th day after
admission.

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