“Hot & Bothered” Hyperthermic Toxidromes

#criticalCare #toxicology #fever

Five potentially life threatening toxidromes (sympathomimetic overdose, anticholinergic overdose, serotonin syndrome, neuroleptic malignant syndrome, and malignant hyperthermia) can all present with overlapping clinical features: hyperthermia, altered mental status/seizures, rhabdomyolysis. Careful history and physical exam are essential to differentiate and a combination of supportive care (ABCs, cooling, etc) and specific therapies can be life-saving. This OnePager reviews the features of each with historical/exam pearls to differentiate.