Differentials
Sepsis
SIGNS / SYMPTOMS
Patients may present with fever and rigors. However, a lowered temperature is possible (particularly in very young patients and older adult patients) and the presentations may be indistinguishable.
INVESTIGATIONS
Blood and urine cultures and tracheal aspirate with Gram stain analysis may show a pathogen. WBC may be elevated but this is not sensitive or specific for sepsis.
Hypothyroidism
SIGNS / SYMPTOMS
Cases that mimic hypothermia most commonly result from long-standing hypothyroidism. Typical symptoms include cold intolerance, fatigue, weight gain, constipation, a deep voice, coarse hair, and dry skin.
Severe hypothyroidism may result in myxoedema coma. Myxoedema refers to non-pitting oedema of skin and soft tissue. An associated change in level of consciousness (not necessarily coma) is present.
Concurrent infection or noncompliance with thyroid replacement medications may precipitate myxoedema coma in a patient with hypothyroidism.
INVESTIGATIONS
Thyroid function tests show a high thyroid-stimulating hormone and low free thyroxine/triiodothyronine (T4/T3).
Use of this content is subject to our disclaimer