Heparin-Induced Fever in Neurointensive Care Unit: A Rarity Yet a Possibility

Abstract

Fever is considered a protective response having multitude of benefits in terms of enhancing resistance to infection, recruiting cytokines to the injured tissue, and promoting healing. In terms of an injured brain, this becomes a double-edged sword triggering an inflammatory cascade resulting in secondary brain injury. It is important to identify the etiology so that corrective measures can be taken. Here we report a case of persistent fever in a patient with Guillain-Barré syndrome, which was probably due to heparin. This is the first report of heparin-induced fever in a neurocritical care setting and third report overall.

Heparin-Induced Fever in a Cardiac Transplant Candidate

“…3 Three prior case reports have documented drug fever secondary to heparin with fever onset between 10 to 14 days of medication initiation and defervescence within 48 hours of discontinuation. 4 5 6 In our case, the patient had intermittent low-grade fevers to 37.5°C (99.5°F) prior to an escalation to 38.8°C (102°F) on day 24 and defervesced 24 hours after heparin was stopped.…”

Enoxsaparin Induced Fever after Orthopedic Surgery

“…In another case, a baby born after 26 + 3 weeks of pregnancy developed after recognizing coagulation disorders after detecting coagulation disorders with dalteparinin's fever (8). In a different case, a 32-year-old patient with Guillain- Barré syndrome was diagnosed with deep vein thrombosis on routine ultrasound and developed fever after heparin therapy (9). Findings of another case, a 50-year-old man who underwent external fixation after a tibial plateau fracture developed fever to postoperatively administered enoxaparin.…”