WHEN TO SUSPECT?.............. CNS dysfunction in a previously healthy individual with ‘fever’

and history of exposure to predisposing risk factors.

History:

·       Exposure to heat stress, either from increased endogenous production or from environmental sources, is essential for the diagnosis of heat exhaustion or heat stroke.

HEAT EXHAUSTION

·       Symptoms are often nonspecific and may be insidious in onset. The symptoms oftenresemble a viral illness.

·       Fatigue and weakness

·       Nausea and vomiting

·       Headache

·       Dizziness

·       Muscle cramps and myalgia

·       Irritability

HEAT STROKE

·       This condition may be characterized by all of the symptoms of heat exhaustion.

·       The critical feature of heat stroke is central nervous system dysfunction, which has a sudden onset in 80% of cases and may include bizarre behaviour, hallucinations or alterations of mental status .

·       Sweating may be present . Anhidrosis, while a classic feature of heat stroke, may be absentover half the time, especially with exertional heat stroke, and is usually a late finding.

Physical examination :

Always ask for a core body temperature to be taken for patients who come to the Emergency Department with CNS Dysfunction and ‘Fever’.