IMPLICATIONS: A combination of unusual environmental factors may have altered the intracellular skeletal muscle milieu to induce or exacerbate a malignant hyperthermia -like response in this patient.

• 不正常的环境因素的联合可能改变细胞内骨骼肌肉环境，从而导致或者加剧这个患者的恶性高热样的反应。