Hot and Cold: Malignant Hyperthermia Without Fever in a Burn Patient.
Chloe K Nobuhara, Pooja Yesantharao, Jesse Tai et al.
✦ AI-curated · Sources linked
Case in brief
A 38-year-old female with a 23% total body surface area flame burn experienced a malignant hyperthermia (MH) crisis during tangential excision under sevoflurane anesthesia. Despite significant metabolic derangements, including hypercapnia, acidosis, and hyperkalemia, she did not exhibit fever or the typical hyperthermic response. The crisis was promptly recognized, and dantrolene was administered, resulting in rapid recovery.
What made this case unusual
The patient presented with malignant hyperthermia without the classic symptom of fever, which is atypical given her extensive burn injuries that impaired thermoregulation.
Diagnostic / clinical pearl
Clinicians should be aware that malignant hyperthermia can occur without fever in patients with extensive burns, complicating diagnosis and management.
Why it matters
This case highlights the need for heightened vigilance in recognizing malignant hyperthermia in atypical presentations, especially in patients with compromised thermoregulation.