Too Hot to Handle: A Case Report of Extreme Pyrexia After MDMA Ingestion
Fritz‐patrick Jahns, Antonine Pineau Mitchell, Georg Auzinger
Therapeutic Hypothermia and Temperature Management April 25, 2018 DOI: 10.1089/ther.2018.0002 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 16-year-old male admitted to an adult intensive care unit after ecstasy intake |
| Interventions | endovascular cooling catheter fasciotomy multiorgan support |
| Duration | 4 weeks in the ICU |
| Topics | MDMA |
| Keywords | Intensive care unit Intensive care medicine Coagulopathy Multiorgan failure Adverse effect |
| Citations | 30 |
| Key findings | Survival after MDMA-induced hyperpyrexia above 43°C is possible with rapid cooling, multiorgan support, and intensive care management. |
Abstract
Hyperpyrexia is a well-documented adverse effect of 3,4-methylenedioxymethamphetamine (MDMA) and is associated with a poor prognosis. There are currently limited published records of patients surviving a pyrexia of or greater than 43°C after MDMA intake. Rapid cooling and multiorgan support in an intensive care setting may offer patients the best chance of recovery. We present the case of a 16-year-old male who was admitted to our tertiary, adult intensive care unit (ICU) for unrecordable pyrexia (>43°C) after reported ecstasy intake. The patient went on to develop severe multiorgan failure and profound disseminated intravascular coagulopathy. Initial patient management focused on rapid cooling using an endovascular cooling catheter and rigorous monitoring and treatment of autonomic symptoms, followed by subsequent surgical therapy (fasciotomy) and multiorgan support. The patient eventually achieved a good clinical outcome after 4 weeks of management in the ICU, and was discharged well to his local hospital. Despite multiple end-organ dysfunctions and often severely poor prognosis, survival after severe hyperpyrexia induced by MDMA intake is possible with proper management and organ support in an appropriate intensive care environment.
Comparable studies
Other case reports and case series on MDMA, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| 'Eve' and 'Ecstasy'. A report of five deaths associated with the use of MDEA and MDMA Individuals whose deaths were associated with MDMA or MDEA use | 1987 | Case series | n = 5 |
| Pathology of deaths associated with "ecstasy" and "eve" misuse. Young white men aged 20 to 25 who died after using ring-substituted amphetamines (MDMA... | 1996 | Case series | n = 7 |
| 'Eve' and 'Ecstasy' Individuals who died after using MDMA or MDEA | 1987 | Case series | n = 5 |
| A Method of Conducting Therapeutic Sessions with MDMA Clients with clear therapeutic purpose, excluding those with serious functional... | 1998 | Case study | n = 2 |
| Diversity of Psychopathology Associated with use of 3,4-Methylenedioxymethamphetamine (‘Ecstasy’) Psychiatric patients presenting between 1990 and 1992 whose symptoms developed in the... | 1994 | Case series | n = 13 |
Citations in the library
Cited by 3
- Neurotoxicity of MDMA: Main effects and mechanisms. Experimental Neurology October 1, 2021
- Use of the CytoSorb adsorption device in MDMA intoxication: a first-in-man application and in vitro study Intensive Care Medicine Experimental June 21, 2020
- Neuronal and peripheral damages induced by synthetic psychoactive substances: an update of recent findings from human and animal studies. Neural Regeneration Research May 1, 2020
Cites 6
- Brain hyperthermia induced by MDMA (‘ecstasy’): modulation by environmental conditions European Journal of Neuroscience July 1, 2004
- Multiple MDMA (Ecstasy) Overdoses at a Rave Event Journal of Intensive Care Medicine May 28, 2012
- Effects of MDMA on body temperature in humans Temperature October 31, 2014
- Dantrolene in the treatment of MDMA-related hyperpyrexia: a systematic review. CJEM September 2010
- Acute toxic effects of 'Ecstasy' (MDMA) and related compounds: overview of pathophysiology and clinical management. British Journal of Anaesthesia June 2006
and 1 more in the library