Hyperpyrexia, hemorrhagic shock and encephalopathy, and creatinine phosphokinase.

Sir. —In his October 1990 editorial in AJDC , Corrigan 1 recommends that the "H" in the syndrome of hemorrhagic shock and encephalopathy (HSE) stand for hyperpyrexia. This is a welcome suggestion to the clinician because it underscores hyperpyrexia as an important clue to the diagnosis of this new syndrome. In February 1985, we were at a loss to explain a difficult patient who showed clinical symptoms of heatstroke. The original description of HSE by Levin et al 2 in 1983 did not view hyperpyrexia as a prominent feature of this disorder. Only two of the 10 patients described had temperatures of 41°C or greater. It was not until a subsequent report 3 emphasized hyperpyrexia that we were alerted to the similarity between our case and those being described in the literature. Patient Report. —A 3-year-old black girl was well until 11 pm on the evening of admission, when she vomited