His total CK levels were elevated (1,654 unit/L) upon arrival and trended down over his 68-hour hospital course. The patient’s troponin-T, creatinine kinase myocardial b fraction (CK-MB), and total CK levels were monitored to identify any cardiac or global muscle damage. The patient tested positive for blood (3+) and albumin (1+) in the urine, and was diagnosed with myoglobinuria and admitted to the intensive care unit for hemodynamic monitoring and resuscitation. Dark purple ecchymosis is visible on the patient’s knees from his fall to the ground after the strike (B) Superficial linear flash burn (black arrow), punctate burns (white dotted arrow), and small abrasions over left nipple (C) Lichtenberg figure lesions on the lateral right thigh (black dotted arrow). Dark linear flash burn on left anterior thigh (black arrow). Superficial punctate burn on left anterior thigh (white dotted arrow). Lichtenberg figure lesions on anterior right thigh (black dotted arrow). The patient also presented with an open wound on the left lateral ankle his shoe had been burnt and blown off by the strike.Ĭutaneous injuries on patient one: (A) Small superficial thermal burns where the patient’s belt buckle contacted the skin (white arrows). Distinct Lichtenberg figure lesions were observed on the anterior right thigh ( Image 1A) as well as on the right and left lateral thighs ( Image 1C). ![]() Superficial flash burns were also observed on the patient’s trunk and anterior thighs, and ecchymosis was observed on the patient’s knees, resulting from his fall to the ground. Minor superficial thermal contact burns were observed below his belt buckle ( Image 1A). ![]() Small abrasions were also observed above the scrotum area and the left nipple, and partial thickness punctate burns were observed on the anterior left thigh and over the left nipple ( Images 1A and 1B). He sustained multiple burn injuries, including superficial burns on the anterior trunk and legs ( Image 1). Chest and pelvic radiography as well as computed tomography (CT) of the head and cervical spine were normal. A focused assessment with sonography for trauma (FAST) and abdominal examination were negative and there was no evidence of compartment syndrome or internal injury. His vitals were normal and he was in normal sinus rhythm (NSR) with no heart murmurs. The patient presented, alert, oriented, and responsive with a Glasgow Coma Score (GCS) of 15, but complained of diffuse pain. He recalled falling to his knees and losing sensation in his left leg and subsequently suffered loss of consciousness for a very short period of time post-strike. He presented with superficial and partial thickness cutaneous injuries. Their unique lightning burns and treatment are discussed.Ī 40-year-old male was struck by lightning while walking in a rainstorm holding an umbrella in an open parking lot. While several published case reports describe the injuries of individuals struck by lightning, this report presents a couple that was simultaneously struck by lightning while walking arm-in-arm in the rain holding an umbrella between them. 1 The risk presented by this high strike density in conjunction with the large population density and favorable climate for outdoor and water activities has earned Florida the reputation as the “Lightning Capital of the United States.” 2, 3 Although being struck by lightning is considered an uncommon occurrence, Florida has more than twice as many lightning-related casualties and fatalities than any other state and averages approximately 10 fatalities per year. ![]() In Florida, the heat and humidity of the subtropical climate creates optimal conditions for thunderstorms the density of lightning strikes is approximately 30 strikes/km 2 per year, relatively high on the global scale and the highest in the U.S. In the United States, the National Weather Service estimates the odds of being struck by lightning in a given year as approximately one in a million.
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