Morphological diagnosis of hyperthermia-related deaths

Hyperthermia, characterized by a core temperature of over 40 degrees C, occurs when the body's thermoregulatory mechanisms are no longer able to dissipate heat. From a clinical point of view hyperthermia can be of three main types: (1) a consequence of an imbalance between anti and pro-inflammatory agents (usually in septic conditions), (2) heatstroke and (3) malignant hyperthermia. Death caused by hyperthermia, either heatstroke or malignant hyperthermia, is diagnosed at the autopsy mainly using seric, histopathological and imunohistochemical methods. Even though unspectific morphological lesions are found in almost every organ, the most affected are skeletal muscles, gut, kidneys and brain. We present here a case of severe hyperthermia leading to heatstroke and discuss the main diagnostic methods available to the forensic pathologist.