Central fever: a challenging clinical entity in neurocritical care

Fever is probably the most frequent symptom observed in the neurointensive care unit (NICU) by healthcare providers. An oral temperature greater than 37.5°C is considered a fever [1,2]. Hyperpyrexia is usually a diagnosis of exclusion, with temperatures exceeding 41°C and nonresponsiveness to antipyretic treatment [3,4]. Fever is seen in almost 70% of neurocritically ill patients [5-10]. Fever of central origin was first described by in the journal Brain by Erickson [11] in 1939. A significant number of these patients have fever from noninfectious causes (47% in Kilpatrick et al. [6] and 25% in Commichau et al. [7]), but this is ofCentral fever: a challenging clinical entity in neurocritical care Keshav Goyal, MD, DM; Neha Garg, MD; Parmod Bithal, MD Department of Neuroanaesthesiology and Critical Care, Neurosciences Centre, All India Institute of Medical Sciences, New Delhi, India Institute of Liver and Biliary Science, Delhi, India Department of Anesthesiology, King Fahd Medical City, Riyadh, Saudi Arabia Review Article