DELAYED MALIGNANT HYPERTHERMIA AFTER RECENT SURGERY

TOPIC: Critical Care TYPE: Medical Student/Resident Case Reports INTRODUCTION: Malignant hyperthermia is a rare reaction of extreme fever and muscle rigidity to agents used for sedation anesthesia. Typically, the within minutes anesthesia administration. In this case report, we will discuss 35-year-old male who had 11 hours postoperatively. CASE PRESENTATION: A with history HIV, anemia, alcohol abuse came hospital due right hip fracture sustained during seizure episode at home, he was also found be in withdrawal. On day 2 early morning, underwent total replacement extubated post-op successfully. Sevoflurane Rocuronium were achieve Post op, patient hemodynamically stable hydromorphone pain control along dexmedetomidine evening 2000h, became agitated muscular rigidity. His rectal temperature 107 F. labs CK-1000, K-4.4, Mg-1.2. Peripheral smear showed no hemolysis. Rectal acetaminophen dantrolene cool saline administered while blood cultures drawn empiric antibiotics started suspected infection. The responded therapy promptly remained afebrile throughout night. Due improving symptoms, discontinued. after 24 transferred out ICU. DISCUSSION: but life-threatening commonly inhaled anesthetics depolarizing relaxants. It mediated by an autosomal dominant mutation gene RYR1 (ryanodine receptor), heterozygous receptor has been associated delayed onset malignant hyperthermia. CONCLUSIONS: Cases have reported occur as late four days relaxant Therefore, it important consider cause hyperpyrexia patients undergone recent surgery. REFERENCE #1: Rosenberg H, Sambuughin N, Riazi S, Dirksen RT (2003, updated January 31, 2013) susceptibility. GeneReviews, eds Pagon RA, et al. (University Washington, Seattle). Available https://www.ncbi.nlm.nih.gov/books/NBK1146/. Accessed March 30, 2017. #2: Monnier Procaccio V, Stieglitz P, Lunardi J (1997) Malignant-hyperthermia susceptibility alpha 1-subunit human dihydropyridine-sensitive L-type voltage-dependent calcium-channel skeletal muscle. Am Hum Genet 60:1316–1325. DISCLOSURES: disclosure on file Sourabh Bidhan; Fred Bittner; No relevant relationships Zachary Johnson, source=Web Response Muhammad Kashlan, Verisha Khanam,