Suspected Malignant Hyperthermia in a Child with Post-Facial Burn Hypertrophic Scars and Ectropion: A Case Report at Kenyatta National Hospital

Belinda Namisi; Betty Owure

doi:doi:10.11648/j.ijmcr.20220104.13

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Suspected Malignant Hyperthermia in a Child with Post-Facial Burn Hypertrophic Scars and Ectropion: A Case Report at Kenyatta National Hospital

Belinda Namisi, Betty Owure

Published in International Journal of Medical Case Reports (Volume 1, Issue 4)

Received: 13 November 2022 Accepted: 7 December 2022 Published: 27 December 2022

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Abstract

Malignant hyperthermia is a rare pharmacogenetic disorder of skeletal muscles. It occurs after subjection to potent volatile anaesthetics, succinylcholine and environmental agents like heat and strenuous exercise. Symptoms of malignant hyperthermia are variable based on age and the common symptoms being hyperthermia, tachycardia and hypercarbia. Dantrolene is the universal treatment of choice. The main aim of this case presentation was to highlight the successful management of malignant hyperthermia without the use of dantrolene. This was a case report of a one year and eleven months old baby who presented thirteen months post facial burn with hypertrophic scars, ectropion and contractures of the mouth. The patient was scheduled for contracture release of the mouth and ectropion repair. Intraoperatively, she had symptoms of suspected malignant hyperthermia such as hyperthermia (38.9°C), hypercarbia (PETCO₂> 55) and tachycardia (heart rate 202bpm). Dantrolene the drug of choice was available but had expired. Supportive care was initiated and patient managed successfully. The patient was extubated on the table uneventfully, taken to recovery and transferred to the wards afterwards. She recovered fully without any sequale of hyper metabolic crisis post operatively and was discharged home after two weeks. This case report illustrates that early recognition of malignant hyperthermia is the key to improved patient survival. Aggressive supportive care can lead to good outcomes even in the absence of the drug dantrolene.

Published in	International Journal of Medical Case Reports (Volume 1, Issue 4)
DOI	10.11648/j.ijmcr.20220104.13
Page(s)	45-49
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2022. Published by Science Publishing Group

Keywords

Malignant Hyperthermia, Hypercabia, Volatile Anaesthetics, Pharmacogenetic, Capnograph

References

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[5]	S. W. Yoo, S. J. Baek, D.-C. Kim, and A. R. Doo, “A case report of malignant hyperthermia in a patient with myotonic dystrophy type I: A CARE-compliant article.,” Medicine (Baltimore)., vol. 100, no. 23, p. e25859, Jun. 2021, doi: 10.1097/MD.0000000000025859.
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[8]	M. G. Larach, B. W. Brandom, G. C. Allen, G. A. Gronert, and E. B. Lehman, “Cardiac arrests and deaths associated with malignant hyperthermia in north america from 1987 to 2006: a report from the north american malignant hyperthermia registry of the malignant hyperthermia association of the United States.,” Anesthesiology, vol. 108, no. 4, pp. 603–611, Apr. 2008, doi: 10.1097/ALN.0b013e318167aee2.
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[12]	H. Rosenberg, N. Pollock, A. Schiemann, T. Bulger, and K. Stowell, “Malignant hyperthermia: a review,” Orphanet J. Rare Dis., vol. 10, p. 93, Aug. 2015, doi: 10.1186/s13023-015-0310-1.
[13]	V. S. Pillai, R. C. Koshy, M. Balakrishnan, and R. Ramakrishnan, “Malignant hyperthermia in India: Time for awakening, useful facts on Dantrolene,” Egypt. J. Anaesth., vol. 31, no. 1, pp. 81–83, 2015, doi: https://doi.org/10.1016/j.egja.2014.09.002.
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APA Style

Belinda Namisi, Betty Owure. (2022). Suspected Malignant Hyperthermia in a Child with Post-Facial Burn Hypertrophic Scars and Ectropion: A Case Report at Kenyatta National Hospital. International Journal of Medical Case Reports, 1(4), 45-49. https://doi.org/10.11648/j.ijmcr.20220104.13

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ACS Style

Belinda Namisi; Betty Owure. Suspected Malignant Hyperthermia in a Child with Post-Facial Burn Hypertrophic Scars and Ectropion: A Case Report at Kenyatta National Hospital. Int. J. Med. Case Rep. 2022, 1(4), 45-49. doi: 10.11648/j.ijmcr.20220104.13

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AMA Style

Belinda Namisi, Betty Owure. Suspected Malignant Hyperthermia in a Child with Post-Facial Burn Hypertrophic Scars and Ectropion: A Case Report at Kenyatta National Hospital. Int J Med Case Rep. 2022;1(4):45-49. doi: 10.11648/j.ijmcr.20220104.13

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@article{10.11648/j.ijmcr.20220104.13,
  author = {Belinda Namisi and Betty Owure},
  title = {Suspected Malignant Hyperthermia in a Child with Post-Facial Burn Hypertrophic Scars and Ectropion: A Case Report at Kenyatta National Hospital},
  journal = {International Journal of Medical Case Reports},
  volume = {1},
  number = {4},
  pages = {45-49},
  doi = {10.11648/j.ijmcr.20220104.13},
  url = {https://doi.org/10.11648/j.ijmcr.20220104.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmcr.20220104.13},
  abstract = {Malignant hyperthermia is a rare pharmacogenetic disorder of skeletal muscles. It occurs after subjection to potent volatile anaesthetics, succinylcholine and environmental agents like heat and strenuous exercise. Symptoms of malignant hyperthermia are variable based on age and the common symptoms being hyperthermia, tachycardia and hypercarbia. Dantrolene is the universal treatment of choice. The main aim of this case presentation was to highlight the successful management of malignant hyperthermia without the use of dantrolene. This was a case report of a one year and eleven months old baby who presented thirteen months post facial burn with hypertrophic scars, ectropion and contractures of the mouth. The patient was scheduled for contracture release of the mouth and ectropion repair. Intraoperatively, she had symptoms of suspected malignant hyperthermia such as hyperthermia (38.9°C), hypercarbia (PETCO2> 55) and tachycardia (heart rate 202bpm). Dantrolene the drug of choice was available but had expired. Supportive care was initiated and patient managed successfully. The patient was extubated on the table uneventfully, taken to recovery and transferred to the wards afterwards. She recovered fully without any sequale of hyper metabolic crisis post operatively and was discharged home after two weeks. This case report illustrates that early recognition of malignant hyperthermia is the key to improved patient survival. Aggressive supportive care can lead to good outcomes even in the absence of the drug dantrolene.},
 year = {2022}
}

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TY - JOUR
T1 - Suspected Malignant Hyperthermia in a Child with Post-Facial Burn Hypertrophic Scars and Ectropion: A Case Report at Kenyatta National Hospital
AU - Belinda Namisi
AU - Betty Owure
Y1 - 2022/12/27
PY - 2022
N1 - https://doi.org/10.11648/j.ijmcr.20220104.13
DO - 10.11648/j.ijmcr.20220104.13
T2 - International Journal of Medical Case Reports
JF - International Journal of Medical Case Reports
JO - International Journal of Medical Case Reports
SP - 45
EP - 49
PB - Science Publishing Group
SN - 2994-7049
UR - https://doi.org/10.11648/j.ijmcr.20220104.13
AB - Malignant hyperthermia is a rare pharmacogenetic disorder of skeletal muscles. It occurs after subjection to potent volatile anaesthetics, succinylcholine and environmental agents like heat and strenuous exercise. Symptoms of malignant hyperthermia are variable based on age and the common symptoms being hyperthermia, tachycardia and hypercarbia. Dantrolene is the universal treatment of choice. The main aim of this case presentation was to highlight the successful management of malignant hyperthermia without the use of dantrolene. This was a case report of a one year and eleven months old baby who presented thirteen months post facial burn with hypertrophic scars, ectropion and contractures of the mouth. The patient was scheduled for contracture release of the mouth and ectropion repair. Intraoperatively, she had symptoms of suspected malignant hyperthermia such as hyperthermia (38.9°C), hypercarbia (PETCO2> 55) and tachycardia (heart rate 202bpm). Dantrolene the drug of choice was available but had expired. Supportive care was initiated and patient managed successfully. The patient was extubated on the table uneventfully, taken to recovery and transferred to the wards afterwards. She recovered fully without any sequale of hyper metabolic crisis post operatively and was discharged home after two weeks. This case report illustrates that early recognition of malignant hyperthermia is the key to improved patient survival. Aggressive supportive care can lead to good outcomes even in the absence of the drug dantrolene.
VL - 1
IS - 4
ER -

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Author Information

Belinda Namisi

Department of Anaesthesia, Faculty of Health Sciences, University of Nairobi, Nairobi, Kenya
Betty Owure

Department of Anaesthesia, Kenyatta National Hospital, Nairobi, Kenya

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APA Style

Belinda Namisi, Betty Owure. (2022). Suspected Malignant Hyperthermia in a Child with Post-Facial Burn Hypertrophic Scars and Ectropion: A Case Report at Kenyatta National Hospital. International Journal of Medical Case Reports, 1(4), 45-49. https://doi.org/10.11648/j.ijmcr.20220104.13

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ACS Style

Belinda Namisi; Betty Owure. Suspected Malignant Hyperthermia in a Child with Post-Facial Burn Hypertrophic Scars and Ectropion: A Case Report at Kenyatta National Hospital. Int. J. Med. Case Rep. 2022, 1(4), 45-49. doi: 10.11648/j.ijmcr.20220104.13

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AMA Style

Belinda Namisi, Betty Owure. Suspected Malignant Hyperthermia in a Child with Post-Facial Burn Hypertrophic Scars and Ectropion: A Case Report at Kenyatta National Hospital. Int J Med Case Rep. 2022;1(4):45-49. doi: 10.11648/j.ijmcr.20220104.13

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@article{10.11648/j.ijmcr.20220104.13,
  author = {Belinda Namisi and Betty Owure},
  title = {Suspected Malignant Hyperthermia in a Child with Post-Facial Burn Hypertrophic Scars and Ectropion: A Case Report at Kenyatta National Hospital},
  journal = {International Journal of Medical Case Reports},
  volume = {1},
  number = {4},
  pages = {45-49},
  doi = {10.11648/j.ijmcr.20220104.13},
  url = {https://doi.org/10.11648/j.ijmcr.20220104.13},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmcr.20220104.13},
  abstract = {Malignant hyperthermia is a rare pharmacogenetic disorder of skeletal muscles. It occurs after subjection to potent volatile anaesthetics, succinylcholine and environmental agents like heat and strenuous exercise. Symptoms of malignant hyperthermia are variable based on age and the common symptoms being hyperthermia, tachycardia and hypercarbia. Dantrolene is the universal treatment of choice. The main aim of this case presentation was to highlight the successful management of malignant hyperthermia without the use of dantrolene. This was a case report of a one year and eleven months old baby who presented thirteen months post facial burn with hypertrophic scars, ectropion and contractures of the mouth. The patient was scheduled for contracture release of the mouth and ectropion repair. Intraoperatively, she had symptoms of suspected malignant hyperthermia such as hyperthermia (38.9°C), hypercarbia (PETCO2> 55) and tachycardia (heart rate 202bpm). Dantrolene the drug of choice was available but had expired. Supportive care was initiated and patient managed successfully. The patient was extubated on the table uneventfully, taken to recovery and transferred to the wards afterwards. She recovered fully without any sequale of hyper metabolic crisis post operatively and was discharged home after two weeks. This case report illustrates that early recognition of malignant hyperthermia is the key to improved patient survival. Aggressive supportive care can lead to good outcomes even in the absence of the drug dantrolene.},
 year = {2022}
}

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