Bacterial translocation in heat stroke

The American Journal of Emergency Medicine
Paula RamírezMiguel Ruano

Abstract

The scientific community is fully aware of the importance of heat-related illness and heat stroke syndrome. Numerous guidelines have been recently published and most of them agree on the key role played by the intestine. Likewise, the role of endotoxinemia in the pathophysiology is well established. However, the possibility of bacterial translocation is not mentioned. Our patient illustrates the likelihood of bacterial translocation in heat stroke and consistently the potential need of antibiotic therapy. A 45-year-old man diagnosed with paranoid schizophrenia was confined in a penitentiary center. One summer day in which a temperature of 41 degrees C was observed in the shade, the patient was found in deep coma with an axillary temperature of 42 degrees C. Multiorgan failure was detected in the hospital. Other causes of coma and/or hyperthermia were excluded, and heat stroke was diagnosed. Blood cultures were positive for Pseudomonas aeruginosa and Escherichia coli. Infection site was not identified despite of an exhaustive search. The patient fully recovered after 48 hours. On the basis of review of the literature, we think that bacterial translocation can take part in the pathophysiology of heat stroke. Therefore, antibiotic...Continue Reading

References

Aug 1, 1997·Critical Care Medicine·E S NylénA Alzeer
Jun 21, 2002·The New England Journal of Medicine·Abderrezak Bouchama, James P Knochel
Mar 29, 2008·Intensive Care Medicine·Pierre HausfaterBruno Riou

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Citations

Mar 25, 2015·The Journal of Emergency Medicine·Daniel Case, Richard Harrigan
Dec 24, 2010·Respiration; International Review of Thoracic Diseases·Rosa CremadesGloria Royo
Sep 12, 2015·Journal of Applied Physiology·Karol DokladnyPope L Moseley

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