Treatment of fever after stroke: Conflicting evidence

Sylwia E. Wrotek, Wieslaw E. Kozak, David C. Hess, Susan C. Fagan

Research output: Contribution to journalReview article

27 Scopus citations

Abstract

Approximately 50% of patients hospitalized for stroke develop fever. In fact, experimental evidence suggests that high body temperature is significantly correlated to initial stroke severity, lesion size, mortality, and neurologic outcome. Fever occurring after stroke is associated with poor outcomes. We investigated the etiology of fever after stroke and present evidence evaluating the efficacy and safety of interventions used to treat stroke-associated fever. Oral antipyretics are only marginally effective in lowering elevated body temperature in this population and may have unintended adverse consequences. Nonpharmacologic approaches to cooling have been more effective in achieving normothermia, but whether stroke outcomes can be improved remains unclear. We recommend using body temperature as a biomarker and a catalyst for aggressive investigation for an infectious etiology. Care must be taken not to exceed the new standard of a maximum acetaminophen dose of 3 g/day to avoid patient harm.

Original languageEnglish (US)
Pages (from-to)1085-1091
Number of pages7
JournalPharmacotherapy
Volume31
Issue number11
DOIs
StatePublished - Nov 1 2011

Keywords

  • Fever
  • Hyperthermia
  • Inflammation
  • Stroke

ASJC Scopus subject areas

  • Pharmacology (medical)

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