🌡️ Neurogenic Fever

Neurogenic fever is a non-infectious, centrally mediated elevation of body temperature resulting from acute brain injury, typically without identifiable infection or systemic inflammation.

• 📍 Cause: Disruption of hypothalamic thermoregulation due to:
  1. Subarachnoid hemorrhage
  2. Traumatic brain injury (TBI)
  3. Stroke
  4. Brain tumors or surgery
• 🔬 Mechanism: Dysautonomia, hypothalamic injury, cytokine release
• 🦠 No infection: Negative cultures, normal procalcitonin/CRP
• 🌡️ High fever: Often >39°C, resistant to standard antipyretics
• 🔄 Pattern: Persistent or episodic, non-circadian

• Often misdiagnosed as sepsis or infection
• Leads to antibiotic overuse, delayed diagnosis, and prolonged ICU stay
• May require:
  1. External cooling
  2. Bromocriptine
  3. Beta-blockers
  4. NSAIDs
  5. Clonidine

• Infectious fever (pneumonia, UTI, meningitis)
• Drug fever
• Deep vein thrombosis / PE
• Autoimmune or paraneoplastic fever

Early recognition of neurogenic fever allows for targeted management and avoidance of unnecessary antibiotics or invasive tests.