Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2023; 11(10): 2355-2362
Published online Apr 6, 2023. doi: 10.12998/wjcc.v11.i10.2355
Full neurological recovery from severe nonexertional heat stroke with multiple organ dysfunction: A case report
Fang Du, Jun-Wei Zheng, Yan-Bo Zhao, Kai Yang, Hu-Nian Li
Fang Du, Yan-Bo Zhao, Kai Yang, Hu-Nian Li, Emergency and Critical Care Center, Hubei University of Medicine, Renmin Hospital, Shiyan 442000, Hubei Province, China
Jun-Wei Zheng, Department of Anesthesiology, Hubei University of Medicine, Renmin Hospital, Shiyan 442000, Hubei Province, China
Author contributions: Du F was a major contributor in writing the original manuscript; Zheng JW, Zhao YB and Yang K provided clinical data, consulted literature, editing, and review; Li HN contributed to project design and operation, data interpretation, supervision, review, and revision of manuscripts; All authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any case data.
Conflict-of-interest statement: All the authors declare no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hu-Nian Li, MM, Associate Chief Physician, Associate Professor, Emergency and Critical Care Center, Hubei University of Medicine, Renmin Hospital, No. 39 Chaoyang Middle Road, Shiyan 442000, Hubei Province, China. 1217209787@qq.com
Received: December 26, 2022
Peer-review started: December 26, 2022
First decision: January 30, 2023
Revised: February 5, 2023
Accepted: March 9, 2023
Article in press: March 9, 2023
Published online: April 6, 2023
Processing time: 94 Days and 5 Hours
Abstract
BACKGROUND

We report a rare case of full neurological recovery from severe nonexertional heat stroke in a 67-year-old woman with an initial Glasgow Coma Scale of 3. This report raises awareness among doctors that when heatstroke is diagnosed, comprehensive treatment should be implemented as soon as possible. Moreover, targeted temperature management, combination therapy with hemodialysis and hemoperfusion, and hyperbaric oxygen therapy may alleviate multiorgan failure and prevent neurological sequelae caused by heatstroke.

CASE SUMMARY

A previously healthy 67-year-old woman with an initial Glasgow Coma Scale of 3 was found lying prone on the road at noon on a summer day. Laboratory tests revealed multiorgan failure. As soon as heatstroke was diagnosed, comprehensive treatment was implemented. On hospital Day 3, the patient was extubated. Her initial Sequential Organ Failure Assessment score at hospitalization was 14 and decreased to 2 on hospital Day 4. On the seventh day following hospital admission, as the patient’s general condition improved, the levels of laboratory test findings decreased rapidly. Finally, the patient gradually recovered with no other neurological symptoms (the Glasgow Coma Scale at discharge was 15, and her ability to walk independently was restored).

CONCLUSION

This case demonstrated that targeted temperature management, combination therapy with hemodialysis and hemoperfusion, and hyperbaric oxygen therapy may alleviate multiorgan failure and prevent neurological sequelae caused by heatstroke.

Keywords: Heat stroke; Multiple organ failure; Neurological; Recovery; Case report

Core Tip: We report a rare case of full neurological recovery from severe nonexertional heat stroke in a 67-year-old woman. As soon as heatstroke was diagnosed, comprehensive treatment was implemented. Laboratory tests revealed multiorgan failure. However, the patient gradually recovered consciousness with no other neurological symptoms. This case demonstrated that targeted temperature management, combination therapy with hemodialysis and hemoperfusion, and hyperbaric oxygen therapy may alleviate multiorgan failure and prevent neurological sequelae caused by heatstroke.