Krishnan Shyam Sundar, Nigam Pulak, Bachh Omar, Vasudevan Madabushi Chakravarthy
Post-Graduate Institute of Neurological Surgery, Dr. Achanta Lakshmipathi Neurosurgical Centre, Voluntary Health Services Multi-speciality Hospital and Research Centre, Chennai, Tamil Nadu, India.
Indian J Crit Care Med. 2018 Jan;22(1):43-45. doi: 10.4103/ijccm.IJCCM_295_17.
Hyperpyrexia is a rare and at times fatal condition seen in an Intensive Care Unit setup. We encountered a case of a 65-year-old patient with road traffic accident presenting with dorsal spine fracture at D level. He underwent decompression and fusion for the same. He developed hyperpyrexia of sudden onset on the 10 day of admission with no source of infection and adequate broad-spectrum antibiotic coverage with adequate thrombo-embolic prevention in place. The patient showed no response to antipyretic agents and other cooling methods. The origin of hyperthermia was idiopathic, and we speculate that the cause was secondary to hyperthermic thermoregulatory dysfunction often quoted as "quad fever," seen in spinal cord injury. We present a brief review of literature and the importance of early identification and treatment of this potentially fatal condition.
高热是重症监护病房中一种罕见且有时会致命的病症。我们遇到了一例65岁的交通事故患者,其D级胸椎骨折。他为此接受了减压和融合手术。入院第10天,他突然出现高热,无感染源,已给予充分的广谱抗生素治疗,并采取了适当的血栓栓塞预防措施。患者对退烧药和其他降温方法均无反应。发热原因不明,我们推测其原因是继发于脊髓损伤中常被称为“四肢发热”的热调节功能障碍。我们简要回顾了相关文献以及早期识别和治疗这种潜在致命病症的重要性。