Hypothermia after Cooling Therapy in Exertional Heat Stroke: A Case Study

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Sarinpant Pongpant, MD
Pitchaya Phakthongsuk, MD
Rungsun Bhurayanontachai, MD


Exertional heat stroke is an emergency condition which can be found inoccupational settings. Pre-hospital and medical management is essential for preventionof morbidity and mortality. A 33-year old male ranger was sent to a district hospitalpresenting with unconsciousness and generalized tonic-clonic seizure. His had an axillarytemperature of 42ºC, blood pressure of 60/40 mmHg and heart rate of 160 beats perminute (bpm), His blood glucose level was 59 mg/dL. Exertional heat stroke wassuspected. He was resuscitated, intubated, medicated and referred to a tertiary hospital.During an hour of transportation, his body was submerged in ice and water. At thetertiary hospital, his esophageal temperature was 29ºC with presentation of Osborn wavein electrocardiogram and electrolyte imbalances. After rewarming and correction ofelectrolytes in the intensive care unit, he gained consciousness the following day. A dayafter that, hyperthermia developed from Enterococcus faecalis septicemia whichresponded to medication. On admission day 6, physical examination showed onlyweakness of his right nasolabial fold. Although this patient had minor complications,lethal or serious outcomes could have occurred in this patient. This report emphasizes theneed for early recognition and proper medical care in heat illness.


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Pongpant S, Phakthongsuk P, Bhurayanontachai R. Hypothermia after Cooling Therapy in Exertional Heat Stroke: A Case Study. BKK Med J [Internet]. 2018Sep.20 [cited 2020Jul.15];14(2):76. Available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/222565
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