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Robert Carter III, Samuel N. Cheuvront and Michael N. Sawka


We report our observations on one soldier with abnormal hyperthermia during exercise in the heat compared with prior exercise and following acute local (non-febrile) infection. Also, we report on 994 heat stroke hospitalizations in the U.S. Army. It is known that prior infection is a risk factor for heat illness and some of the 37 heat stroke deaths cited infections (eg, pneumonia, influenza) in the medical records.


This case report illustrates complete recovery from abnormal hyperthermia, which occurred in a laboratory setting during mild, low intensity exercise. In a field setting, this case may have resulted in serious heat illness. As with most of the heat stroke cases, rapid medical attention (ie, cooling and rehydration) and the age group (19 to 26) that represents majority of the heatstroke cases in U.S. Army are likely factors that contribute successful treatment of heatstroke in the field environment.


We conclude that acute inflammatory response can augment the hyperthermia of exercise and possibly increase heat illness susceptibility. Furthermore, it is important for health care providers of soldiers and athletes to monitor acute local infections due to the potential thermoregulatory consequences during exercise in the heat.

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Samuel N. Cheuvront, Robert Carter III, Scott J. Montain and Michael N. Sawka

The purpose of this study was to quantify the variability and stability of 1st morning body mass (BM) fluctuations during daily exercise in the heat while following traditional fluid intake guidance. Data from 65 men were examined retrospectively. BM fluctuations were monitored over 4 to 15 consecutive days. Group daily variation in BM was 0.51 ± 0.20 kg. Group coefficient of variation was 0.66 ± 0.24%, normally distributed, and not related to either absolute BM (r = 0.04) or number of measurements (r = 0.34). Three days resulted in a similar variability estimate compared to 6 or 9 d, although precision was improved with 9 d. In conclusion, 3 consecutive BM measurements provide an accurate assessment of daily BM variability, which is less than 1% for active men when replacing 100% of sweat losses during exercise. The data also suggest that daily BM is a sufficiently stable physiological parameter for potential daily fluid balance monitoring.