Fatal Fever of Unknown Origin in Acute Cervical Spinal Cord Injury: Five Cases

Ülger, Fatma; Dilek, Ahmet; Karakaya, Deniz; Şenel, Alparslan; Sarıhasan, Binnur

doi:10.1080/10790268.2009.11760788

Cited by 23 publications

(20 citation statements)

References 21 publications

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“…The average duration of fever was 5.2 days. 10 Although this small case series sounds a cautionary note regarding the prognosis of patients with acute traumatic SCI with fever of unknown etiology, it remains unknown whether such patients have a worse prognosis compared with patients with acute traumatic SCI with fever of known origin. [1][2][3][4] According to Colachis and Otis, fever duration for patients with SCI during acute care was significantly longer (4.9 days) than during the rehabilitation period (1.9 days).…”

Section: Clinical Outcomes Of Thermoregulation Dysfunction and Neurogmentioning

confidence: 87%

Neurogenic Fever after Acute Traumatic Spinal Cord Injury: A Qualitative Systematic Review

Savage

Oleson

Schroeder

et al. 2016

Global Spine Journal

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Study Design Systematic review.Objective To determine the incidence, pathogenesis, and clinical outcomes related to neurogenic fevers following traumatic spinal cord injury (SCI).Methods A systematic review of the literature was performed on thermodysregulation secondary to acute traumatic SCI in adult patients. A literature search was performed using PubMed (MEDLINE), Cochrane Central Register of Controlled Trials, and Scopus. Using strict inclusion and exclusion criteria, seven relevant articles were obtained.Results The incidence of fever of all origins (both known and unknown) after SCI ranged from 22.5 to 71.7% with a mean incidence of 50.6% and a median incidence of 50.0%. The incidence of fever of unknown origin (neurogenic fever) ranged from 2.6 to 27.8% with a mean incidence of 8.0% and a median incidence of 4.7%. Cervical and thoracic spinal injuries were more commonly associated with fever than lumbar injuries. In addition, complete injuries had a higher incidence of fever than incomplete injuries. The pathogenesis of neurogenic fever after acute SCI is not thoroughly understood.Conclusion Neurogenic fevers are relatively common following an acute SCI; however, there is little in the scientific literature to help physicians prevent or treat this condition. The paucity of research underscored by this review demonstrates the need for further studies with larger sample sizes, focusing on incidence rate, clinical outcomes, and pathogenesis of neurogenic fever following acute traumatic SCI.

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Section: Clinical Outcomes Of Thermoregulation Dysfunction and Neurogmentioning

confidence: 87%

Neurogenic Fever after Acute Traumatic Spinal Cord Injury: A Qualitative Systematic Review

Savage

Oleson

Schroeder

et al. 2016

Global Spine Journal

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show abstract

“…Similar findings could be expected in dogs. On the other hand, humans with cervical spinal cord injuries are at risk of autonomic dysfunction including thermo-dysregulation and pyrexia (quad fever), which may be fatal [33]. Although the authors of the present paper are not aware of such descriptions in dogs, quad fever could be considered in dogs with cervical spinal cord injuries with unexplained pyrexia.…”

Section: Discussionmentioning

confidence: 97%

Acute non-ambulatory tetraparesis with absence of the dens in two large breed dogs: case reports with a radiographic study of relatives

et al. 2013

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BackgroundNon-ambulatory tetraparesis with an absence of the dens of C2 (axis) has not previously been reported in large breed dogs. An absence or hypoplasia of the dens has been reported in both small, medium and large breed dogs, but not in closely related animals.MethodsTwo young large-breed dogs (a German shepherd and a Standard poodle) both with an acute onset of non-ambulatory tetraparesis were subjected to physical, neurological and radiographic examinations. Both dogs were euthanased and submitted for postmortem examination within one week of onset of clinical signs. To investigate possible heritability of dens abnormalities, oblique radiographs of the cranial cervical vertebrae were taken of nine and eighteen dogs related to the German shepherd and the Standard poodle, respectively.ResultsAbsence of the dens, atlantoaxial instability and extensive spinal cord injury was found in both case dogs. Radiographs revealed a normal dens in both parents and in the seven littermates of the German shepherd. An absence or hypoplasia of the dens was diagnosed in six relatives of the Standard poodle.ConclusionsAtlantoaxial subluxation with cervical spinal cord injury should be considered as a differential diagnosis in non-ambulatory tetraparetic young large breed dogs. Absence of the dens and no history of external trauma increase the likelihood for this diagnosis. This study provides evidence to suggest that absence or hypoplasia of the dens is inherited in an autosomal way in Standard poodle dogs.

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“…Ulger et al [2] have described a series of five cases of cervical spine injury with persistent hyperthermia who had uniformly fatal outcomes due to uncontrolled severe hyperthermia defined as a core temperature >39°C [5].…”

Section: Discussionmentioning

confidence: 99%

“…Sustained hyperthermia unresponsive to commonly employed physical and pharmacologic interventions may be attributed to a thermoregulatory disorder seen in this subgroup of patients. Sometimes known as quad fever, with an incidence of 28%, it has been seen to have a high incidence of morbidity and mortality [2,3].…”

Section: Introductionmentioning

confidence: 99%