I. Maurice Ndukwu, MD, MPH; Jane E. Dematte, MD; Karen O'Mara, DO
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Ndukwu IM, Dematte JE, O'Mara K. Features and Outcomes of Classic Heat Stroke. Ann Intern Med. 1999;130:614-615. doi: 10.7326/0003-4819-130-7-199904060-00026
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Published: Ann Intern Med. 1999;130(7):614-615.
We appreciate these comments and the opportunity to respond. Although we agree with some of the comments of Drs. Ayus and Arieff, we do not believe that disturbances in serum sodium levels were responsible for the neurologic impairment in our patients. Serum sodium levels at admission were not substantially abnormal in our patients. In addition, sodium values at admission did not differ among patients with minimal or no impairment and those with moderate to severe impairment at discharge.
We agree with Dr. Bouchama that the role of infection in the pathogenesis of heat stroke remains to be elucidated. We believe that the increased incidence of infection seen in our patients is real. Similar to Dr. Bouchama's study, our study included only the results of cultures drawn within the first 24 hours of admission. We believe that our patient sample may have been dissimilar enough from Dr. Bouchama's to explain the differences between his results and ours. The premorbid condition of his patients allowed travel and pilgrimage; this suggests that they were healthier than our patients.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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