• Etiology: Exogenous heat exposure (e.g., heat stroke) and endogenous heat production (e.g., drug-induced hyperthermia, malignant hyperthermia) are two mechanisms by which hyperthermia can result in dangerously high internal temperatures.
    • Heat stroke: Thermoregulatory failure in association with a warm environment; can be categorized as exertional (e.g., due to exercise in high heat or humidity) or classic (typically occurring in pts with chronic diseases that predispose to heat-related illnesses)
  • Clinical features: High core temperature in association with an appropriate history (heat exposure, certain drug treatments) and dry skin, hallucinations, delirium, pupil dilation, muscle rigidity, and/or elevated levels of CPK
  • Diagnosis: It can be difficult to distinguish fever from hyperthermia. The clinical history is often most useful (e.g., a history of heat exposure or of treatment with drugs that interfere with thermoregulation).
    • Hyperthermic pts have hot, dry skin; antipyretic agents do not lower the body temperature.
    • Febrile pts can have cold skin (as a result of vasoconstriction) or hot, moist skin; antipyretics usually result in some lowering of the body temperature.

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