Fever in a hospitalized patient

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Fever in the hospitalized patient

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
Decoupling of oxidative phosphorylation, as in drug-induced

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

![Causes of drug-induced hyperthermia](Drug-induced hyperthermia.png)

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