Exertional heatstroke. Lethal multiorgan failure due to hyperthermia in a 23-year-old sportsman

We report the case of a 23-year-old rower who suffered from an exertional h eatstroke while trying to lose 2 kg in weight by jogging before a competiti on. The development of this illness was favoured by clothes that were inapp ropriate for the environmental conditions and which the sportsman wore inte ntionally to enhance sweating. The maximum core temperature was over 43 deg reesC. As a consequence the comatose patient developed a fulminant multi-or gan failure with the liver ceasing its function, renal failure, massive rha bdomyolysis, and disseminated intravascular coagulation. In addition, he su ffered from pericardial effusion and acute pulmonary failure (ARDS). In spi te of maximum intensive care with an extensive substitution of blood produc ts, continuous hemodiafiltration, and inhalative administration of nitrous oxide the young sportsman died 48 h after his admission to the intensive ca re unit. This tragic course demonstrates the danger of the widespread habit of losin g weight by vigorously exercising with inappropriate clothes. In this artic le, potential risk factors, symptomatology, therapy, and methods of prevent ing an exertional heatstroke are shown and discussed.