• G Strecker, P Adnet, A P Forget, and R Krivosic-Horber.
• Département d'anesthésie-réanimation chirurgicale I, hôpital R-Salengro, Lille, France.
• Ann Fr Anesth Reanim. 1997 Jan 1;16(3):234-8.

ObjectiveTo assess the possibility to differentiate clinically intraoperative malignant hyperthermia (MH) and sepsis.Study DesignComparative retrospective study of clinical cases.PatientsSixteen patients operated on for acute appendicitis and developing clinical signs of MH confirmed or not by in vitro caffeine halothane contracture tests (IVCT).MethodTo isolate the patients' characteristics with regard to the diagnosis of sepsis and MH crisis. To compare both groups of clinical features with results of IVCT.ResultsThe diagnosis of MH sensitivity has been excluded in ten hyperthermic patients and confirmed in four others with IVCT. No correlation was existing between the importance of perioperative sepsis, MH features and IVTC results.ConclusionsThis study confirmed the difficulty to differentiate clinically MH and sepsis during surgery. Considering the severe outcome of MH crisis, it is recommended to start the specific therapy even in case of appendicular sepsis.

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