Fever in a hospitalized patient

From IDWiki

Background

Definition

  • Core temperature >38.3ºC

Pathophysiology

  • Pyrogenic fever is caused by endogenous (IL-1, IL-6, TNF-alpha) or exogenous (from a microbe) pyrogen compounds
    • Either direct action or cytokine production that stimulates the organum vasculosum of the lamina terminalis (OVLT) in the hypothalamus
  • Neurogenic fever
  • Decoupling of oxidative phosphorylation, as in drug-induced fever

Differential Diagnosis

  • Infectious
  • Non-infectious
    • Inflammatory diseases
    • Drug-induced, including ß-lactam antibiotics, sulphonamides, antipsychotics, propofol
    • Traumatic brain injury or ischemic brain injury
    • Endocrine fever