• Rafal Banek, John Weatherwax, Dennis Spence, Susan Perry, Sheila Muldoon, and John Capacchione.
• Naval Medical Center San Diego, CA, USA. rafal.banek@med.navy.mil
• AANA J. 2013 Dec 1; 81 (6): 441-5.

AbstractMalignant hyperthermia (MH) is a rare pathologic hypermetabolic pharmacogenetic disorder of skeletal muscle calcium regulation following exposure to depolarizing muscle relaxants and/or volatile anesthetics. Although its pathogenesis is relatively well understood, there is wide variability in both the time of onset and the presentation of clinical signs and symptoms. In some circumstances the delayed onset of the hypermetabolic state may hinder timely recognition and treatment. Differential diagnosis of an MH crisis can be particularly challenging in a trauma patient, especially in an austere environment. This case report describes the presentation and management of a suspected case of MH in an Afghan national who underwent surgery following lower extremity trauma resulting from an improvised explosive device.

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