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General Rehabilitation

Idiopathic Hypothermia in Acute Rehabilitation Status-Post Stem Cell Transplant: A Case Report

Thursday, October 23, 2025
12:45 PM - 2:15 PM MT
Location: Kiosk 2

    Poster Presenter(s)

  • Sofie Janette (she/her/hers)

    Medical Student
    University of Miami Miller School of Medicine
    Coconut Grove, Florida

    • Co-Author(s)

  • NH

    Nazia Hossain, MD

    Resident Physician
    University of Miami/Jackson Health System PM&R Program
    Miami, Florida

  • Diana Molinares-Mejia, MD

    Cancer Rehabil Director. Residency Program Director
    University of Miami/Jackson Health System PM&R Program
    Miami, Florida

Disclosure(s):
Sofie Janette: No financial relationships to disclose
Diana Molinares-Mejia, MD: No financial relationships to disclose
Case Diagnosis: This is a case of a 69-year-old man with mixed phenotype acute leukemia (MPAL) status post-stem-cell transplant (SCT) whose rehabilitation stay was complicated by transfusion-related hypothermia. Multidisciplinary management of allowed for uninterrupted comprehensive rehabilitation course that resulted in a safe discharge home with excellent return in function.

Case Description or Program Description: A 69-year-old male with a history of MPAL was admitted to an inpatient rehab facility (IRF) 42 days after a successful SCT. On admission to IRF, the patient was pancytopenic on tacrolimus, antimicrobial prophylaxis (acyclovir, fluconazole, and atovoquone), and status-post multiple red blood cell transfusions in acute hospital. Patient required multiple transfusions in IRF as well; initial two transfusions were complicated by hypothermia. Given the patient's severely immunocompromised status, a full infectious work-up was initiated and infectious disease, internal medicine and hematology were consulted. Per infectious disease recommendations, the patient was empirically started on daptomycin, piperacillin/tazobactam, and micafungin.

Setting: Acute Rehabilitation Facility

Assessment/Results: Infectious workup was negative and the. patient continued to participate in therapy with good progress and no further hypothermic episodes. The patient progressed from maximal assistance to the supervision level in most functional domains. He was later discharged home with outpatient therapy, ambulating 300 feet with a rolling walker.

Discussion (relevance): Patients with recent SCT are medically complex, often with near-complete immunosuppression and pancytopenia. SCT patients have a high rate of transfer back to the primary acute service with high mortality thereafter. Infection accounts for almost 30% of transfers back to acute. Thus, it is crucial to maintain a high degree of suspicion for infection, especially in the setting of abnormal vital signs.

Conclusions: SCT patients represent a medically fragile subset of cancer rehabilitation patients with a high rate of transfer back to primary acute service. Close monitoring and timely interventions may reduce patients’ risk of medical complications and ensure completion of the rehabilitation course.