Hypothermia in the tropics. A review of 24 cases.

The clinical features in a series of 24 patients with hypothermia treated at Mulago Hospital, Kampala, are described. Hypothermia developed in all when the environmental temperature did not fall below 16 degrees. There was a preponderance of males; 14 of the 24 cases were over 50 years old. The most common predisposing factors were severe undernutrition or malnutrition with wasting and almost complete absence of subcutaneous fat, and anaemia present in over two thirds of the patients. Hypoglycaemia appeared to be the immediate precipitating factor in at least five patients. Acute pancreatitis was found in three of the four patients who died unexpectedly 2-7 days after recovery from hypothermia; focal pancreatitis and fat necrosis was also present in six other cases. It is concluded that hypothermia is not uncommon, and is a dangerous complication amongst patients with severe under- or malnutrition, and can occur even under "tropical" conditions, when the environmental temperature does not fall below 16 degrees.