Methamphetamine Overdose and Hyperthermia in a 41-Year-Old Man Found Unresponsive

This case examines the death of a 41-year-old man due to acute methamphetamine toxicity and severe hyperthermia. The patient was found unresponsive with a pulse and spontaneous respirations along a beach in Southeast Texas. Local weather at noon in late August was reported as 92°F (33.3°C) with 60% humidity. On arrival at the emergency department, he was unresponsive with agonal respirations and no palpable pulse. His core body temperature was 108.6°F (42.6°C) measured rectally, one of the highest temperatures recorded in a patient with a methamphetamine overdose who had a pulse and was breathing. Despite aggressive resuscitation and active cooling for 30 minutes, he was pronounced dead with a final temperature of 104.3°F (40.2°C). Postmortem toxicology from femoral blood revealed a methamphetamine concentration of 680 ng/mL and an amphetamine concentration of 55 ng/mL. This case provides an opportunity to discuss the multiple mechanisms through which stimulants contribute to hyperthermia as well as potential treatment strategies.