PMID- 29694265
OWN - NLM
STAT- MEDLINE
DCOM- 20190107
LR  - 20190107
IS  - 2153-7933 (Electronic)
IS  - 2153-7658 (Linking)
VI  - 8
IP  - 3
DP  - 2018 Sep
TI  - Too Hot to Handle: A Case Report of Extreme Pyrexia After MDMA Ingestion.
PG  - 173-175
LID - 10.1089/ther.2018.0002 [doi]
AB  - Hyperpyrexia is a well-documented adverse effect of 
      3,4-methylenedioxymethamphetamine (MDMA) and is associated with a poor prognosis. 
      There are currently limited published records of patients surviving a pyrexia of 
      or greater than 43 degrees C after MDMA intake. Rapid cooling and multiorgan support in 
      an intensive care setting may offer patients the best chance of recovery. We 
      present the case of a 16-year-old male who was admitted to our tertiary, adult 
      intensive care unit (ICU) for unrecordable pyrexia (>43 degrees C) after reported ecstasy 
      intake. The patient went on to develop severe multiorgan failure and profound 
      disseminated intravascular coagulopathy. Initial patient management focused on 
      rapid cooling using an endovascular cooling catheter and rigorous monitoring and 
      treatment of autonomic symptoms, followed by subsequent surgical therapy 
      (fasciotomy) and multiorgan support. The patient eventually achieved a good 
      clinical outcome after 4 weeks of management in the ICU, and was discharged well 
      to his local hospital. Despite multiple end-organ dysfunctions and often severely 
      poor prognosis, survival after severe hyperpyrexia induced by MDMA intake is 
      possible with proper management and organ support in an appropriate intensive 
      care environment.
FAU - Jahns, Fritz-Patrick
AU  - Jahns FP
AD  - 1 Adult Intensive Care Unit, King's College Hospital NHS Foundation Trust , 
      London, United Kingdom .
AD  - 2 King's College London School of Medicine , London, United Kingdom .
FAU - Pineau Mitchell, Antonine
AU  - Pineau Mitchell A
AD  - 2 King's College London School of Medicine , London, United Kingdom .
FAU - Auzinger, Georg
AU  - Auzinger G
AD  - 1 Adult Intensive Care Unit, King's College Hospital NHS Foundation Trust , 
      London, United Kingdom .
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20180425
PL  - United States
TA  - Ther Hypothermia Temp Manag
JT  - Therapeutic hypothermia and temperature management
JID - 101543518
RN  - 0 (Hallucinogens)
RN  - KE1SEN21RM (N-Methyl-3,4-methylenedioxyamphetamine)
SB  - IM
MH  - Adolescent
MH  - Fever/*chemically induced/*therapy
MH  - Hallucinogens/*adverse effects
MH  - Humans
MH  - *Hypothermia, Induced
MH  - Male
MH  - N-Methyl-3,4-methylenedioxyamphetamine/*adverse effects
OTO - NOTNLM
OT  - MDMA
OT  - endovascular cooling
OT  - extreme pyrexia
EDAT- 2018/04/26 06:00
MHDA- 2019/01/08 06:00
CRDT- 2018/04/26 06:00
PHST- 2018/04/26 06:00 [pubmed]
PHST- 2019/01/08 06:00 [medline]
PHST- 2018/04/26 06:00 [entrez]
AID - 10.1089/ther.2018.0002 [doi]
PST - ppublish
SO  - Ther Hypothermia Temp Manag. 2018 Sep;8(3):173-175. doi: 10.1089/ther.2018.0002. 
      Epub 2018 Apr 25.