Diaphoresis

Diaphoresis is the production of profuse sweating, often in a context of illness or autonomic arousal. The term, derived from Greek, is used in medical contexts to describe sweating that accompanies acute distress, rather than normal thermoregulatory sweating. It can occur with fever, infection, pain, anxiety, shock, hypoglycemia, or other systemic conditions, and may be seen in conjunction with various medical emergencies.

Physiology and clinical significance: Sweat production is primarily mediated by eccrine glands that are regulated by the sympathetic nervous system. Diaphoresis reflects activation of these pathways and can indicate significant physiologic stress or an evolving medical problem. While it can accompany benign conditions such as anxiety, it can also herald serious emergencies, notably cardiovascular or infectious processes, making it a potentially important clinical sign.

Common causes: Diaphoresis may accompany cardiovascular events (for example, acute coronary syndrome or myocardial infarction), shock, or dehydration. It is also seen with infections and sepsis, fever, pneumonia, and other inflammatory states; metabolic or endocrine crises such as diabetic ketoacidosis or thyroid storm; severe hypoglycemia; respiratory or pain syndromes; heat-related illnesses; and drug effects or withdrawal (including alcohol or opioid withdrawal) or other acute intoxications.

Evaluation and management: In a patient presenting with diaphoresis, clinicians assess vital signs, mental status, and potential life-threatening causes. Diagnostic workup is guided by the clinical context and may include glucose measurement, ECG, pulse oximetry, and laboratory tests to evaluate for infection, metabolic derangements, or organ dysfunction. Management focuses on treating the underlying cause (for example, glucose for hypoglycemia, cooling and fluids for heat illness, analgesia for pain, or appropriate therapy for sepsis or myocardial ischemia) and ensuring adequate hydration and monitoring. Diaphoresis itself is a symptom rather than a standalone diagnosis.