A 50-year-old Japanese male subject, who was healthy before
climbing, arrived at the foot of the Japan Alps (Kamikouchi) at 1,500 m
above sea level on July 21, 1998. The next morning, he started climbing
Mt. Yari (3,180 m) and reached about 2,800 m above sea level. On the
third day, while climbing Mt. Tsubakuro (2,680 m), he developed general
fatigue, followed by headache, cough, and fever (38.0°C) in the
afternoon. His condition progressively deteriorated during the night,
and he was lethargic and comatose. The subject was rescued and admitted
to our Shinshu University Hospital (660 m). On admission, he exhibited
cyanosis and was unconscious. Coarse crackles were audible over both
sides of the lung. Chest radiograph revealed patchy infiltrates in both
lung fields. Arterial blood gas analysis (room air) showed
Pao2 of 31.5 mm Hg,
Paco2 of 36.2 mm Hg, and pH of
7.46. The patient was treated with adequate oxygen and fluid infusion.
No other therapy was administered. His condition gradually improved,
and the infiltration on chest radiograph disappeared within 2 weeks.
Examinations using 123I-MIBG scintigraphy were
performed 7 days and 2 months after admission.