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This illness covers a wide range of severity from the mild symptoms of heat cramps to heat exhaustion and the extreme of life-threatening heat stroke. Development of these conditions is often associated with patient-specific acquired or congenital vulnerability factors such as extremes of age, fitness, obesity, medication use (eg, antipsychotics, anticholinergics, and amphetamines), or chronic disease. Environmental factors such as high humidity and heat are commonly implicated. Our case explores the possible impact of a recent viral illness on temperature regulation and the development of exertional heat illness in an otherwise well-trained athlete.<\/jats:p>","DOI":"10.1177\/10806032261458332","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:04:26Z","timestamp":1781611466000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Icy Hot: A Case of Unexpected Heat Illness"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-1701-6311","authenticated-orcid":false,"given":"Gavin","family":"Clark","sequence":"first","affiliation":[{"name":"Dartmouth Hitchcock Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Kocen","sequence":"additional","affiliation":[{"name":"Dartmouth Hitchcock Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Daniel","sequence":"additional","affiliation":[{"name":"Dartmouth Hitchcock Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,16]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2011.2.1963"},{"key":"e_1_3_2_3_2","volume-title":"Auerbach\u2019s Wilderness Medicine","author":"Auerbach PS","year":"2017","unstructured":"Auerbach PS, Cushing TA, Harris NH. Auerbach\u2019s Wilderness Medicine, Vol 1. 7th ed. Elsevier; 2017:270."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2020.01.007"},{"issue":"2","key":"e_1_3_2_5_2","article-title":"Society of Critical Care Medicine guidelines for the treatment of heat stroke","volume":"53","author":"Barletta J","year":"2025","unstructured":"Barletta J, Palmieri T, Toomey S, AlShamsi F, Stearns RL, Patanwala AE, et al. Society of Critical Care Medicine guidelines for the treatment of heat stroke. 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Self-scored impairments in functioning and disability in post-COVID syndrome following mild COVID-19 infection. 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