Psychogenic fever in a patient with small cell lung cancer: a case report

Xu, Mengdan; Zhang, Xiaoye; Xu, Zhihao; Cui, Guoyuan; Li, Yu; Qi, Xiaoying; Lin, Jia Feng; Liu, Yan

doi:10.1186/s12885-015-1462-z

Cited by 7 publications

(10 citation statements)

References 10 publications

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“…This pathophysiology is independent of the cascade of proinflammatory cytokines and prostaglandin E 2 , so suppression by nonsteroidal antiinflammatory drugs is not possible [ 1 – 3 ]. Several case reports of stress-induced hyperthermia in the perioperative period have been published, but progression to MOF has not been reported [ 10 , 11 ]. The degree of perioperative stimulation required to activate a systemic immune response varies among individuals because of differences in genetic predisposition/susceptibilities [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Postoperative hyperthermia-induced multiple organ failure in a child with Down syndrome: a case report

et al. 2022

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Background Psychological stress has been reported to cause hyperthermia. Persistent excessive hyperthermia can, in turn, cause hypercytokinemia and organ damage. We report a case of postoperative severe hyperthermia leading to a systemic inflammatory response and multiple organ failure in a child with Down syndrome. Case presentation A 10-month-old native Japanese boy with Down syndrome and Hirschsprung’s disease is described. Newborn screening showed congenital hypothyroidism and a ventricular septal defect, but these conditions were stable upon administration of levothyroxine and furosemide. His development was equivalent to that of a child with Down syndrome. He developed a noninfectious high fever twice after preoperative preparations at age 8 months and again at 9 months. He was readmitted to hospital at age 10 months to undergo the Soave procedure to correct Hirschsprung’s disease. However, he contracted a fever immediately after the surgical procedure. Hyperthermia (42 °C) was refractory to acetaminophen treatment and deteriorated to multiple organ failure due to hypercytokinemia, with increased serum levels of interleukin-6 (44.6 pg/mL) and interleukin-10 (1010 pg/mL). He died on postoperative day 2 with hypoxemia, respiratory/metabolic acidosis, increased serum levels of transaminases, reduced coagulation, and pancytopenia. Various infectious and noninfectious causes of hyperthermia could not be identified clearly by culture or blood tests. Conclusions We speculated that the proximate cause of the fever was psychological stress, because he suffered repeated episodes of hyperthermia after the invasive procedure. Hyperthermia, together with the immune-system disorders associated with Down syndrome, may have induced hypercytokinemia and multiple organ failure. This rare case of noninfectious postoperative hyperthermia leading to multiple organ failure may help to shed further light on the currently unclear pathogenic mechanism of hyperthermia and associated multiple organ failure during the perioperative period in children.

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Section: Discussionmentioning

confidence: 99%

Postoperative hyperthermia-induced multiple organ failure in a child with Down syndrome: a case report

et al. 2022

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“…Given that a definitive diagnosis is difficult, there are very few reports concerning psychogenic fever. 5 , 7 , 8 , 9 , 10 Psychogenic fever is underdiagnosed and underestimated because the association between stress and fever is obscure and difficult to prove. 7 A search for English language publications in the PubMed database using the keywords “stress‐induced hyperthermia” and “case report” revealed only five articles (up until July 7, 2020).…”

Section: Discussionmentioning

confidence: 99%

“…However, psychological interventions, including anxiolytics, neuroleptics, and electroconvulsive therapy, relieve fever symptoms dramatically in many cases. 5 , 7 , 8 , 9 , 10…”

Section: Discussionmentioning

confidence: 99%

Psychogenic fever due to worry about COVID‐19: A case report

Imataki

Uemura

2021

Clinical Case Reports

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Psychogenic fever is stress‐related hyperthermia that is recognized as a psychosomatic condition. We treated a 46‐year‐old Japanese man who was worrying about the coronavirus infection (COVID‐19) and had a fever with a maximum temperature of 38.1℃. The patient was tested twice for SRAS‐CoV‐2 using polymerase chain reaction (PCR), but both tests were negative. All tests were negative for organic diseases, including infections, allergy/collagen diseases, endocrine disorders, malignancies, and drugs‐induced conditions. The more he doubted the COVID‐19 in him, the more he complained of the already known various symptoms, such as smelling disorder. The patient believed firmly that he had COVID‐19 because PCR can be false negative. Finally, the patient was treated with the anxiolytic, loflazepate, at 4 mg/day. This treatment was highly effective. The patient's serum IL‐6 was 1.1 pg/ml (≤4.0). The patient was diagnosed with psychogenic fever due to irrational worry over coronavirus. Such typical cases should be treated with an anxiolytic.

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“…Thus, older patients may require benzodiazepines for anxiety. In fact, four cases older than 50 years identified in our literature review received benzodiazepines alone or in combination with SSRIs to treat anxiety [9][10][11][12].…”

Section: Discussionmentioning

confidence: 99%

Effective Therapy Against Severe Anxiety Caused by Cancer: A Case Report and Review of the Literature

Sakamoto

Koyama

2020

Cureus

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Anxiety can make it difficult for patients to manage their illness. Therefore, it is important to reduce their anxiety if possible. However, few studies have examined the efficacy of drugs in the treatment of anxiety in patients with cancer. Our case had failed to respond to benzodiazepines, and it was difficult to use a selective serotonin reuptake inhibitor (SSRI) as the next drug. This case report describes the effective use of quetiapine to treat anxiety. We report this rare case along with a literature review. Few studies have assessed the treatment of anxiety in patients with rare cancers. In our case, quetiapine effectively alleviated anxiety associated with cystic adenoid carcinoma. However, in clinical practice, it is possible that anxiety is treated without differentiating the effects of cancer status, e.g. life prognosis, treatment progress. In our patient, benzodiazepines had no effect on anxiety. Thus, different drugs may be required to treat anxiety associated with cancer. The present study demonstrated that quetiapine is a useful modality for the palliative care of patients with rare cancer and intractable anxiety. Quetiapine may be an effective alternative to benzodiazepines (BZ) and SSRIs for treating anxiety in patients with cancer. However, further investigation is needed to clarify the efficacy of treatments for anxiety associated with rare cancers.

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Psychogenic fever in a patient with small cell lung cancer: a case report

Cited by 7 publications

References 10 publications

Postoperative hyperthermia-induced multiple organ failure in a child with Down syndrome: a case report

Postoperative hyperthermia-induced multiple organ failure in a child with Down syndrome: a case report

Psychogenic fever due to worry about COVID‐19: A case report

Effective Therapy Against Severe Anxiety Caused by Cancer: A Case Report and Review of the Literature

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