Revista del Instituto Nacional de Enfermedades Respiratorias
Print version ISSN 0187-7585
CASTILLO ORTEGA, Graciano and SOLIS, Carolina. Pulmonary hemorrhage and acute respiratory distress syndrome secondary to heat stroke. Rev. Inst. Nal. Enf. Resp. Mex. [online]. 2006, vol.19, n.4, pp. 276-281. ISSN 0187-7585.
Heat stroke is a rare and underdiagnosed entity, it is more frequently seen in the northern states of Mexico after exposure to high environmental temperatures that induce elevation of the body temperature, triggering metabolic derangements that can result in death. We present the case of a 24 year old immigrant from the southeast state of Chiapas found in the Desert of Altar, in the northern state of Sonora; he was semiconscious, dehydrated and in poor general condition after attempting to cross the desert in his way to the border with the USA. He was brought to our hospital with labored breathing, hemoptysis, lung infiltrates and progressive deterioration of his blood gases. He was intubated and mechanically ventilated; the initial course was characterized by increased CPK levels suggestive of rabdomyolisis, acute renal failure, disseminated intravascular coagulation, lung hemorrhage and acute respiratory distress syndrome secondary to the heat stroke. He spent 14 days in the ICU receiving 4 courses of hemodyalisis, ventilatory support, iv fluids, antibiotics and monitoring of his respiratory, renal, cardiovascular, neurologic and metabolic parameters. He was discharged 21 days after admission. Heat stroke prevention is mandatory by public education; early diagnosis should avoid the full-blown systemic derangements; adequate support can reverse an otherwise potentially fatal course.
Keywords : Heat stroke; rabdomyolisis; lung hemorrhage; hemoptysis; ARDS.