Patients frequently present to the Emergency Department with elevated body temperature; the distinction between “fever” and “hyperthermia” is vital. Many commonly prescribed drugs can cause hyperthermia.¹ The goal of treatment is to reduce core temperature and oxygen demand before organ damage occurs.² We present the case of a 14 year old boy who presented with hyperthermia due to a transdermal hyoscine patch used to control his symptoms associated with cerebral palsy.

CASE

A 14 year old boy with spastic quadriplegia presented to the Emergency Department (ED) having been found unresponsive at home in the early hours of the morning. On arrival in the ED he was drowsy and agitated with dilated but reactive pupils and a fever of 42°C. His heart rate was 120/min, blood pressure 100/70 and capillary refill time instant. No rash or neck stiffness was present but it was noted that despite the high fever he was not sweating and he had dry mucous membranes. The presence or absence of urinary retention was not commented on at initial examination. Examination was otherwise unremarkable except for the presence of a gastrostomy feeding tube and a hyoscine patch sited on the skin behind his ear to control oropharyngeal secretions, which was removed. His parents stated that he had been well the previous evening and had no other …