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Malignant hyperthermia following intra vaginal prostaglandin misoprostol is rare. A patient presenting malignant hyperthermia following intra vaginal misoprostol was diagnosed by clinical presentation and routine lab test such as increased level of CPK, increased serum creatinine, metabolic and respiratory acidosis, increase serum potassium and myoglobin in urine. It is important to note that other known causes of malignant hyperthermia were not present. Patients was given iv cold saline, cold water lavage, cold sponging along with supportive care (With stoppage of misoprostol) and complete recovery within 3 days. Hence, here intra vaginal misoprostol should be considered as a triggering agent for malignant hyperthermia.
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