title: Severe exercise-associated hyponatremia on the Kokoda Trail, Papua New Guinea.
abstract: Exercise-associated hyponatremia is the most common medical complication of ultradistance exercise and is usually caused by excessive hypotonic fluid intake. We report a case of severe hyponatremia in a healthy male trekking the Kokoda Trail in the remote Southern Highlands of Papua New Guinea. A 43-year-old male collapsed and had a generalized seizure in the afternoon of the third day of a guided trek. He was evacuated the following morning and was found to have a serum sodium level of 107 mmol/L on arrival to hospital. The case highlights that a high index of suspicion is required to identify patients with exercise-associated hyponatremia. Early diagnosis and appropriate management is critical to avoid the potentially fatal consequences of severe hyponatremia. The diagnosis and treatment of exercise-associated hyponatremia is particularly challenging in the remote Papua New Guinea jungle. Education of trek leaders, medics, and trekkers in appropriate preventative measures and the rapid treatment of exercise-associated hyponatremia is essential to avoid recurrences of this life-threatening condition.
authors.affiliation: Royal Brisbane and Women's Hospital, Queensland, Australia. sean_rothwell@health.qld.gov.au
authors.forename: Sean P
authors.initials: SP
authors.lastname: Rothwell
authors.forename: David J
authors.initials: DJ
authors.lastname: Rosengren
mesh_terms: D000328:Adult; D015444:Exercise / Q000502:physiology; D006801:Humans; D007010:Hyponatremia / Q000209:etiology* / Q000517:prevention & control; D008297:Male; D010219:Papua New Guinea; D010807:Physical Endurance; D012964:Sodium / Q000097:blood*; D014882:Water-Electrolyte Balance / Q000502:physiology*
chemical_list: D012964:Sodium