Case report: exertional heat stroke after moderate effort as a neurological emergency.

Exertional heat stroke can occur even after moderate efforts in persons predisposed to the condition. Consequences can be far-reaching, potentially leading to multi-organ failure and possibly death. We discuss the case of a 23-year old army recruit presenting with altered consciousness and hyperthermia after a training march. Following initial clinical improvement, rising CK and liver enzyme levels as well as increasing INR were recorded. Facing the risk of multi-organ failure, the patient was transferred to a specialized ICU. The condition could be stabilized without recurring to molecular adsorbent recirculation system (MARS). Exertional heat stroke must be readily recognized as such for correct treatment to be initiated. A multi-disciplinary approach is urgently warranted.