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Finish Line Fatigue: Weakness In A Triathlete During A Mass Participation Event - Page #1
 

Author: Brenna Ori, DO
Senior Editor: Heather Rainey, MD
Editor: Jesse Miller, MD

Patient Presentation:
A 19-year-old male triathlete presented to the medical tent at the USA Triathlon following the
completion of an Olympic distance event reporting profound fatigue. The patient stated he felt
well during the whole race, but at the finish line noticed a sudden overwhelming sense of
weakness that felt different than normal post-race fatigue. Other associated symptoms included
mild abdominal pain and some muscle tightness.

History:
The patient reported similar incidents of these
symptoms during past races though admitted that his current symptoms are much milder than they
have been previously. He has required hospitalization for similar symptoms at prior events. His
past medical history is significant for adrenoleukodystrophy status post bone marrow transplant 8
years ago and primary adrenal insufficiency for which he is on hydrocortisone 25mg daily
divided into three doses and fludrocortisone 0.1mg daily.

Physical Exam:
General: Awake, alert, and answering questions appropriately
Skin: Diaphoretic consistent with recent physical exertion
CV: Tachycardic, no murmurs
Respiratory: Lungs clear to auscultation
Abdominal: Soft and not tender to palpation
MSK: Moving all four extremities against gravity, but was unable to stand without assistance due
to weakness.

Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.

NOTE: For more information, please contact the AMSSM, 4000 W. 114th Street, Suite 100, Leawood, KS 66211 (913) 327-1415.
 

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