We report the case of a near-fatal heat stroke in a 41-year-old patient. The comatose patient had a body core temperature of 41.5 degrees C. The clinical course was complicated by systemic inflammatory response syndrome and multiorgan failure. The EEG showed an alpha coma that did not react to external stimuli and, in general, has a poor prognosis. The patient regained consciousness and was discharged from our intensive care unit after 16 days. In the further course cerebral toxoplasmosis developed which was treated with a combination therapy of sulfadiazine and pyrimethamine. The patient was transferred to a neurorehabilitation clinic with a moderate neurological deficit 65 days after heat stroke onset.