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Steroids are used for the prevention and treatment of high-altitude illnesses. However, these agents can cause significant side effects. We report a case of altered mental status, gastrointestinal bleeding, skin rash, and avascular necrosis in a climber taking prophylactic dexamethasone prior to an attempt to climb Mt Everest. High-altitude cerebral edema (HACE), steroid toxicity, and acute adrenal crisis can have similar clinical presentations. Differentiating between these life-threatening conditions at high altitude is essential for successful treatment.

Original publication




Journal article


Wilderness Environ Med

Publication Date





345 - 348


Acute Disease, Adult, Altitude, Altitude Sickness, Confusion, Drug-Related Side Effects and Adverse Reactions, Exanthema, Gastrointestinal Hemorrhage, Humans, Male, Mountaineering, Muscle Weakness, Nepal, Panic Disorder, Steroids