{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T06:30:13Z","timestamp":1785825013772,"version":"3.56.0"},"reference-count":7,"publisher":"Georg Thieme Verlag KG","issue":"01","license":[{"start":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T00:00:00Z","timestamp":1656374400000},"content-version":"vor","delay-in-days":119,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>By definition, \u201cquad fever\u201d is an extreme elevation in body core temperature beyond 40.8\u00b0C (105.4\u00b0F) in a patient with spinal cord injury. This type of central nervous system hyperpyrexia is seen in spinal cord injury patients, particularly those with high cervical spine injury with quadriplegia. However, it has also been described in paraplegics with a mid- or higher level thoracic spine injury. The incidence of \u201cquad fever\u201d is rare, with the highest reported temperature being 44\u00b0C (111.2\u00b0F) with chronicled fatal outcomes.<\/jats:p><jats:p>Though the use of antipyretics is generally efficacious, they are considerably ineffective in treating the hyperpyrexia seen in this type of severe central autonomic thermodysregulation.<\/jats:p><jats:p>Here, we present a case of high cervical spine injury in a 24-year-old male. The trauma resulted in a C3\u20135 level cord contusion with incomplete quadriplegia (ASIA [American Spinal Cord Injury Association Impairment Scale] grade B). The patient developed high grade fever of 106\u00b0F within a week of admission postoperatively.<\/jats:p><jats:p>Pancultures were negative and the wound was clean. Despite treatment with higher antibiotics and an infection disease specialist's consult, no obvious etiology was found. Drug-induced fever and thyroid function tests were excluded in other less-common causes.<\/jats:p><jats:p>Based on the diagnosis of exclusion, \u201cquad fever\u201d was inferred as the cause. He had other signs of autonomic instability during the episodes such as bradycardia with hypotension.<\/jats:p><jats:p>Our patient showed an almost early response to treatment to betablockers and antipsychotics after failure to respond to antibiotics, mechanical hypothermia, and antipyretics.<\/jats:p>","DOI":"10.1055\/s-0042-1748784","type":"journal-article","created":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T00:16:18Z","timestamp":1656461778000},"page":"085-087","source":"Crossref","is-referenced-by-count":4,"title":["Quad Fever in a Case of Cervical Cord Injury\u2014A Rare Case Report"],"prefix":"10.1055","volume":"17","author":[{"given":"Sheena","family":"Ali","sequence":"additional","affiliation":[{"name":"Kovai Medical Centre and Hospital, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duraisamy","family":"Ganesan","sequence":"additional","affiliation":[{"name":"Kovai Medical Centre and Hospital, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varun","family":"Sundaramoorthy","sequence":"additional","affiliation":[{"name":"Kovai Medical Centre and Hospital, Coimbatore, Tamil Nadu, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2022,6,28]]},"reference":[{"issue":"12","key":"ref1","first-page":"697","article-title":"Disorders of temperature regulation","volume":"21","author":"T L Lee-Chiong Jr.","year":"1995","journal-title":"Compr Ther"},{"issue":"06","key":"ref2","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1086\/516144","article-title":"Infections in patients with spinal cord injuries","volume":"25","author":"J Z Montgomerie","year":"1997","journal-title":"Clin Infect Dis"},{"issue":"12","key":"ref3","first-page":"639","article-title":"Fever in recently injured quadriplegic persons","volume":"63","author":"B Sugarman","year":"1982","journal-title":"Arch Phys Med Rehabil"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1682\/JRRD.2005.10.0159","article-title":"Assessment of autonomic dysfunction following spinal cord injury: rationale for additions to International Standards for Neurological Assessment","volume":"44","author":"A V Krassioukov","year":"2007","journal-title":"J Rehabil Res Dev"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1080\/10790268.2009.11760788","article-title":"Fatal fever of unknown origin in acute cervical spinal cord injury: five cases","volume":"32","author":"F Ulger","year":"2009","journal-title":"J Spinal Cord Med"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1080\/0265673031000065042","article-title":"Cellular effects of hyperthermia: relevance to the minimum dose for thermal damage","volume":"19","author":"J R Lepock","year":"2003","journal-title":"Int J Hyperthermia"},{"key":"ref9","first-page":"4826s","article-title":"Pathological effects of hyperthermia in normal tissues","volume":"44","author":"L F Fajardo","year":"1984","journal-title":"Cancer Res"}],"container-title":["Asian Journal of Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0042-1748784.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,13]],"date-time":"2022-07-13T23:08:45Z","timestamp":1657753725000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0042-1748784"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3]]},"references-count":7,"journal-issue":{"issue":"01","published-online":{"date-parts":[[2022,7,13]]},"published-print":{"date-parts":[[2022,3]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0042-1748784","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1793-5482","2248-9614"],"issn-type":[{"value":"1793-5482","type":"print"},{"value":"2248-9614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3]]}}}