Fatal heat stroke. Circulating endotoxin and gram-negative sepsis as complications

Fatal heat stroke occurred in a patient and was complicated by shock, septicemia, anuria, and consumption coagulopathy. The patient also developed endotoxemia, hypocomplementemia, hypoimmunoglobulinemia, and elevated serum lysozyme, which were quantified by immunologic tests. Autopsy findings were consistent with those seen in experimental endotoxic shock and were characterized by numerous fibrin thrombi in arterioles. It may be advisable to perform the Limulus lysate test for the determination of serum endotoxin levels in all cases of heat stroke to obtain new information about the clinical course of such patients and to elucidate the role of circulating endotoxin as a potential fatal mechanism .