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Fever and Central Nervous System Infection

A cool new paper by Saxena and Young examined the relationship between temperature and outcomes of patients with CNS infection and stroke in the Intensive Care Unit. This was an observational study that measured the peak temperature in patients with a variety of CNS diseases, including meningitis. They reasoned that if fever is beneficial in infection, as we have explored in previous blog posts, then having a high temperature should not be associated with higher mortality.

The paper concludes:

Take-home message: (1) This paper suggests that early fever in the context of meningitis and encephalitis is not associated with increased hospital mortality; it is possible that early fever may in fact be beneficial for this patient population. (2) For traumatic brain injury and stroke, early temperature between 37 and 39 °C is not associated with increased hospital mortality; however, for these patient populations early temperature below 37 °C and above 39 °C is associated with increased hospital mortality.

Available in open access here: Early temperature and mortality in critically ill patients with acute neurological diseases: trauma and stroke differ from infection. Intensive Care Med 2015;epublished February 3 2015.

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Joe Alcock

Emergency Physician, Educator, Researcher, interested in the microbiome, evolution, and medicine

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