Hi simon2342,
I?m sorry your brother has had such a rough time lately. Brain tumors
and their after-effects can be difficult to deal with. Please
understand that this answer is for informational purposes only, and is
not intended to diagnose or treat your brother. This answer is not
considered a replacement for sound medical advice from a licensed
physician, who is familiar with your brother's complete medical
history.
Having said that, I have compiled a list of possible ?causes? of fever
in brain tumor/brain injury patients. I can not tell you which, if any
of the following IS causing your brother?s fevers. Because infection
is the usual cause of fever, it is first on my list.
==============
Infection*:
==============
The usual cause of fever is infection, but as you will read, fever
following brain surgery is fairly common. You say your brother is not
receiving any antibiotics. I am assuming the medical staff has found
no source of infection, Has he had blood cultures drawn? Blood
cultures, usually drawn in pairs, fifteen minutes apart, and from
different sites, can diagnose a systemic blood infection.
Additionally, cultures should be taken of your brother?s urine
(especially if he is catheterized), sputum, and surgical incision. If
the fevers continue, a lumbar puncture may be ordered (a lumbar
puncture is commonly known as a ?spinal tap?) to check for infections
organisms in the cerebrospinal fluid.
Seeing as your brother had a staph infection (MRSA-methicillin
resistant Staphylococcus aureus), he probably was treated with
vancomycin, clindamycin or one of the newer antibiotics, quinupristin
dalfopristin or linezolid. These are very strong antibiotics, but is
is possible he has another infection. Cough, sweating, fever and
weight loss may indicate his pneumonia is returning. Organisms
responsible for empyma/lung abscess are Bacteroides species,
Fusobacterium species, and Peptostreptococcus species. Pseudomonas
species, Klebsiella species, Staphylococcus aureus, Streptococcus
pneumoniae, Nocardia species, and fungal species are less commonly
seen. Your doctor should make sure your brother is negative for the
presence of any of these species, in particular. Not to alarm you, but
has your brother been exposed to tuberculosis (TB)?
* Since I wrote the majority of this answer, you have clarified that
he is negative for infection. I?ll leave this information as is, for
reference.
Causes of fever:
1.infections caused by bacteria, ricketsia, chlamydia, viruses, and parasites
2.immune reactions, including defects in collagen, immunological
abnormalities and acquired immunodeficiency
3.destruction of tissues, such as trauma, local necrosis (infarction),
and inflammatory reaction in tissues and vessels (phlebitis,
arteritis), pulmonary infarction, cerebral and myocardial infarction,
and rhabdomyolysis
4.specific inflammations (sarcoidosis, granulomatous hepatitis)
5.inflammation of intestine and intra-abdominal inflammatory processes
6.neoplastic processes with the participation of lymphoendothelial
system and hematopoetic system, solid tumours (Grawitz tumour of the
kidney, carcinoma of the pancreas, pulmonary and skeletal tumours,
hepatoma) Fever is present in complications of solid tumours, usually
in metastases that are associated with necrosis of the tumour,
obstruction of ducts, or with infection
7.acute metabolic failures such as arthritis urica, (sic)porfyria
(porphyria), Addison's crisis, thyrotoxic crisis, and pheochromocytoma
8.administration of some drugs
9.dehydration or admistration of salts. That's why fever occurs
together with diarrhea.
10.administration of foreign proteins (e.g. globulinum
antitetanicum-antitoxic fraction of horse serum) may be the reason of
fever's origin.
http://nic.sav.sk/logos/books/scientific/node47.html#SECTION00530000000000000000
==============
Post-surgical fever is not rare following brain surgery. Inflammation
from a brain injury can trigger a fever, without inflammation. If the
fever rises very quickly, seizures may occur, and this sounds like it
may have occurred with your brother.
?These febrile seizures are caused by rapid increase in temperature,
not by the height of the temperature.?
http://www.drgreene.com/21_349.html
?Thus people with brain injury may have combinations of low blood
oxygen, blood pressure, heart, and lung changes, fever, blood
coagulation disorders, and other adverse changes at recurrent
intervals in the days following brain injury. These occur at a time
when the normal regulatory mechanism by which the cerebrovascular
vessels can relax to maintain an adequate supply of oxygen and blood
during such adverse events is impaired as a result of the original
trauma.?
http://home.iprimus.com.au/rboon/BrainInjury.htm
Incidence of stroke itself causing fever:
?According to Dr. Michael DeGeorgia, a neurologist with the Cleveland
Clinic Foundation, in Cleveland, it makes intuitive sense that
movement in the hypothalamus, which is the brain's temperature control
centre, would cause some disruption in body temperatures. Now, a small
study of 61 patients who were treated for ICH at the Cleveland Clinic
has shown just how that movement might occur.
The third ventricle, which abuts the hypothalamus, was shown in some
patients to move by as much as 3-5 mm. This finding led Dr. DeGeorgia
to speculate that this sets off a chain of events that results in
fever - and neuronal damage. Even movements of as little as 1 mm
caused a marked disruption in body temperatures, he added.?
?A study is now being planned in which patients presenting with
intracerebral hemorrhage will have a special catheter inserted into
the femoral artery and their blood will be cooled as it flows through
the inferior vena cava. It is hoped that this cooling may help control
the fever and minimize the risk of damage from the hemorrhage, he
said.?
http://www.docguide.com/news/content.nsf/news/741DE77D7F195AEA852569F400500E03
?There are situations, when fever may be caused directly by changes in
the center of thermoregulation without the participation of exogenic
and may be also endogenic pyrogens. This occurs in brain tumours,
intracranial bleeding, and thrombosis.?
http://nic.sav.sk/logos/books/scientific/node46.html#SECTION00520000000000000000
?Researchers found that more than 80 percent of patients had
postoperative fevers. Of the patients with fever, 62 percent were
given lumbar punctures, or spinal taps, to diagnose suspected
bacterial meningitis. Only six of these patients were diagnosed with
meningitis, and these children had also complained of headache,
lethargy and wound discharge, which the majority of children with
low-grade fever alone did not experience.?
http://www.hopkinsmedicine.org/press/2002/November/021108.htm
This abstract outlines a study on a patient after brainstem injury.
The patient had altered thermoregulation.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8398019&dopt=Abstract
?Hyperthermia, frequently seen in patients following traumatic brain
injury (TBI), may be due to posttraumatic cerebral inflammation,
direct hypothalamic damage, or secondary infection resulting in
fever.?
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=12742737
?A part of the brain called the hypothalamus controls body
temperature. Fever results from an actual resetting of the
hypothalamus's thermostat. The body raises its temperature to a higher
level by moving (shunting) blood from the skin surface to the interior
of the body, thus reducing heat loss. Shivering (chills) may occur to
increase heat production through muscle contraction. The body's
efforts to conserve and produce heat continue until blood reaches the
hypothalamus at the new, higher temperature. The new, higher
temperature is then maintained. Later, when the thermostat is reset to
its normal level, the body eliminates excess heat through sweating and
shunting of blood to the skin.
Fever may follow a pattern: sometimes temperature peaks every day and
then returns to normal. Alternatively, fever may be remittent, in
which the temperature varies but does not return to normal. Certain
people (for example, alcoholics, the very old, and the very young) may
experience a drop in temperature as a response to severe infection.?
?Usually, fever has an obvious cause, which is often?but not always?an
infection (such as influenza, pneumonia, a urinary tract infection, or
some other infection) that a doctor can easily diagnose with a brief
history, physical examination, and occasionally a few simple tests,
such as a chest x-ray and urine tests. Sometimes, however, the cause
is not readily discernible.?
http://www.merck.com/mmhe/sec17/ch188/ch188d.html
?. Thus people with brain injury may have combinations of low blood
oxygen, blood pressure, heart, and lung changes, fever, blood
coagulation disorders, and other adverse changes at recurrent
intervals in the days following brain injury. These occur at a time
when the normal regulatory mechanism by which the cerebrovascular
vessels can relax to maintain an adequate supply of oxygen and blood
during such adverse events is impaired as a result of the original
trauma.?
http://www.bisociety.org/physiatry.cfm
According to this article, every measure should be taken to lower the
temperature of a stroke patient to avoid more injury to the brain.
?The acutely ischemic or traumatized brain is inordinately susceptible
to the damaging influence of even modest brain temperature elevations.
While controlled clinical investigations will be required to establish
the therapeutic efficacy and safety of frank hypothermia in patients
with acute stroke, the available evidence is sufficiently compelling
to justify the recommendation, at this time, that fever be combatted
assiduously in acute stroke and trauma patients, even if "minor" in
degree and even when delayed in onset. We suggest that body
temperature be maintained in a safe normothermic range (eg, 36.7
degrees C to 37.0 degrees C [98.0 degrees F to 98.6 degrees F]) for at
least the first several days after acute stroke or head injury.?
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9472901&dopt=Abstract
?Recent studies have demonstrated the neuroprotective effects of
moderate hypothermia following traumatic brain injury. Brain cooling
has been shown to protect the brain histopathologically and to improve
functional outcome. These experimental studies have led to the
initiation of clinical trials for hypothermia in humans in traumatic
brain injury. Studies are currently in progress to demonstrate the
potential benefits of hypothermia following spinal cord injury. In
contrast to hypothermia, brain hyperthermia following ischemia and
trauma significantly aggravates outcome. Thus, fever appears to be a
potentially severe secondary injury mechanism that must be avoided in
head or spinal cord injured (SCI) patients.?
http://chroma.med.miami.edu/cellbio/faculty/faculty_dietrich.html
?In experimental studies, cooling animals after causing a stroke
results in significantly less brain injury than if the animal is kept
at normal temperature. Experiments of cooling after stroke have not
yet been done in people, but they probably will be within the next few
years and it wouldn't be surprising if ten years from now it was a
routine part of stroke care. Already there is a centre in Germany that
is lowering the body temperature to 32ºCelsius (89.6ºFahrenheit) for
very severe stroke. The initial reports are encouraging, but need to
be tested in a formal trial first, before they can be recommended.
Other evidence that suggests controlling temperature might be
important is the observation that people who develop a fever after
stroke do less well than those who maintain a normal temperature.
Whether this is because people with a more severe stroke are more
likely to develop a high temperature or that the fever itself is
harmful to a brain that has recently sustained a stroke is not clear.?
http://www.stroke.org.uk/print.rm?id=227
This is a previous answer of mine, pertaining to the hypothalamus and
it?s role in fever.
http://www.answers.google.com/answers/threadview?id=354326
?Stroke patients have an increased risk of DVT and the subsequent
life-threatening complication of pulmonary embolism, which is the most
common cause of death during the 2 to 4 weeks following a stroke.
Careful control of the patient's blood glucose levels and temperature
should also be a priority because hyperglycemia and fever have been
shown to result in poorer outcomes.?
http://www.clevelandclinicmeded.com/diseasemanagement/neurology/stroke/stroke1.htm
?Conditions other than infections can cause fevers. These include
blood clots and heterotopic bone, which are discussed later. Sometimes
the fever can be a result of the brain injury itself and not the
result of an infection. This happens when the part of the brain that
controls the body?s temperature is damaged.?
Blood clots are also common in patients with brain injury and stroke.
Generally, patients are treated with IV heparin while an inpatient,
and oral coumadin once they leave the hospital. (Heparin can not be
administered orally)
http://lifecenter.ric.org/content/2163/?topic=1&subtopic=271
=================
Heterotopic bone
=================
?This refers to formation of extra bone in the body. The extra bone
most often forms in the large joints of the body such as the hip or
the shoulder. It can cause pain, swelling, inflammation and tightening
of the joint. No one knows for certain why people with brain injuries
and other conditions are likely to develop heterotopic bone formation.
However, approximately 10 to 20 percent of people with brain injuries
develop it.?
http://lifecenter.ric.org/content/2163/?topic=1&subtopic=271
?The earliest sign of HO (heterotopic ossification, or heterotopic
bone growth) often is decreased joint ROM.(ROM = Range of motion)
Other findings include swelling, erythema, heat, pain with ROM
testing, and contracture formation, but the condition may be occult.
Fever also may be present. Patients can experience pain, increased
spasticity, vascular and nerve compression, and lymphedema.?
?Physical: Ectopic bone usually forms around major joints (eg, the
elbows, shoulders, hips, knees) following brain injury, as well as
over long-bone fractures. The proximal interphalangeal joints of the
hand, the wrist, and the spine also may be affected. Local pain and a
palpable mass may be noted in the periarticular region, usually
presenting 1-3 months after the injury, but the onset of HO also has
been reported at 1-7 months after severe brain injury.
HO can mimic thrombophlebitis, with pain, swelling, erythema, and
induration of the affected area. If HO affects a joint, a decrease in
ROM often is observed. Major long-term disability from untreated HO
can include limited ROM or even joint ankylosis.?
http://www.emedicine.com/pmr/topic112.htm
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12172519&dopt=Abstract
========================================
Anticonvulsant Hypersensitivity Syndrome
========================================
This syndrome came to mind immediately upon reading your question.
Although it is unlikely your brother has this -- it is rare (1 in
1,000 to 10,000 exposures) -- please read over the following
information.
If your brother is of African American heritage (more common in, but
not limited to African Americans), also has a rash and/or elevated
liver enzymes (can be detected with blood tests), he may have a
sensitivity to phenytoin (Dilantin). AHS is believed to occur because
some people lack the enzyme that metabolizes phenytoin, leading to a
toxic buildup of phenytoin by-products.
?Over 60% of reactions involve more than one organ within the first 48
hours.1,2 Most patients present with a high fever ranging between 38
and 40 degrees C, which may persist for several weeks. This fever is
generally accompanied by a skin rash. The rash typically affects the
upper trunk, extremities and face early on in the reaction, but can
spread to the lower extremities. Often the palms and soles of the feet
are spared. It can be described as an erythematous, edematous, papular
rash, which may or may not be pruritic. Initial stages of the rash are
patchy, later progressing into a more confluent pattern.
Another hallmark presentation of AHS is lymphadenopathy, a tender
condition that can be localized or generalized. Most hyperplasia
associated with lymphadenopathy is benign growth or resolves with
discontinuation of the offending drug. Potentially fatal complications
include hypersensitivity myocarditis and drug-induced hepatitis.
Patients who develop hepatitis (with jaundice) increase their chance
for mortality up to 50%.?
?Anticonvulsant Hypersensitivity Syndrome occurs in some patients
taking anticonvulsant medication. It is characterised by fever, rash,
hepatitis and other multiorgan abnormalities. The mechanism is
unknown. Patients who have experienced this syndrome should not
receive anticonvulsants in the phenytoin category, carbamazepine,
phenobarbitone and lamotrigine.?
http://www.medsafe.govt.nz/Profs/PUarticles/6.htm
http://www.bu.edu/cme/modules/2002/drugerup02/content/4-hyper.htm
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10612272&dopt=Abstract
========================================
Other Drugs that can induce fever
========================================
Antibiotic Induced Fever
A.Erythromycin
B.Isoniazid
C.Penicillin
D.Nitrofurantoin
E.Procainamide
F.Quinidine
Cardiovascular Medication Induced Fever
A.Atropine
B.Captopril
C.Clofibrate
D.Hydralazine
E.Hydrochlorothiazide
F.Methyldopa
G.Nifedipine
Miscellaneous Medications Inducing Fever
A.Allopurinol
B.Antihistamines
C.Aspirin
D.Cimetidine
E.Heparin
F.Meperidine
G.Phenytoin
Since your brother has suffered a stroke, he is likely on IV heparin,
along with his phenytoin.
http://www.fpnotebook.com/ID164.htm
?As with all anticoagulants, the most common adverse reaction with
lepirudin is bleeding, occurring in 3 to 12% of patients, but fever
may also occur.? Lepirudin is a synthetic version of the substance
that leeches inject into flesh when biting to prevent blood clotting,
used in place of heparin.
http://www.clevelandclinicmeded.com/medical_info/pharmacy/septoct2001/thrombocytopenia.htm
========================================
Inflammation:
========================================
?Fever is a natural reaction during a number of illnesses. In several
cases, absence of the natural reaction is more alarming sign than the
presence of fever itself. Fever is usually accompanied by different
general symptoms, such as sweating, chills, sensation of cold, and
other subjective sensations. Missing of these symptoms during high
temperature may be a sign of a serious illness.?
http://nic.sav.sk/logos/books/scientific/node45.html#SECTION00510000000000000000
?Any injury, including an invasion by microorganisms, causes a complex
reaction called inflammation in the affected area. Inflammation occurs
as a result of many different conditions. Through the release of
different substances from the damaged tissue, inflammation directs the
body's defenses to wall off the area, attack and kill any invaders,
dispose of dead and damaged tissue, and begin the process of repair.
However, inflammation may not be able to overcome large numbers of
microorganisms.
During inflammation, the blood supply increases. An infected area near
the surface of the body becomes red and warm. The walls of blood
vessels become more porous, allowing fluid and white blood cells to
pass into the affected tissue. The increase in fluid causes the
inflamed tissue to swell. The white blood cells attack the invading
microorganisms and release substances that continue the process of
inflammation. Other substances trigger clotting in the tiny vessels
(capillaries) in the inflamed area, which delays the spread of the
infecting microorganisms and their toxins. Many of the substances
produced during inflammation stimulate the nerves, producing pain.
Reactions to the substances released during inflammation include the
chills, fever, and muscle aches that commonly accompany infection.?
http://www.merck.com/mmhe/sec17/ch188/ch188d.html
?Fever or pyrexia is a common clinical phenomenon. Among survivors of
traumatic brain injury, it may appear immediately after injury, signal
the presence of infection or reflect dysfunction of the
thermoregulatory system. Management of pyrexia must be distinguished
from measures that seek to identify and remove the putative cause of
fever. Guidelines for decision making regarding the nursing management
of patients with fever are presented. Given the potential benefit of
fever, the ability of most patients to tolerate temperature elevations
and the adverse effects, costs and discomforts associated with
therapy, our habit of automatically reducing temperature should be
examined.?
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1602170&dopt=Abstract
?Fever may be provoked by many stimuli. Most often, they are bacteria
and their endotoxins, viruses, yeasts, spirochets, protozoa, immune
reactions, several hormones, medications, and synthetic
polynucleotides. These substances are commonly called exogenic
pyrogens. Cells stimulated by exogenic pyrogens form and produce
cytokines called endogenic pyrogens. Endogenic pyrogens centrally
affect the thermosensitive neurons in the preoptic area of the
hypothalamus increase the production of heat and decrease in heat
loss. The body temperature increses until it reaches the set point.
This information is transferred by temperature of blood that flows
around the hypothalamus. The decrease of temperature is controlled by
activation of mechanisms regulating increased outcome of heat to the
surrounding area. Increased outcome continues in favourable case until
the new equilibrium is achieved.?
http://nic.sav.sk/logos/books/scientific/node46.html#SECTION00520000000000000000
?Inflammation is a manifestation of the body's response to tissue
damage and infection. The discovery of the detailed processes of
inflammation has revealed a close relationship between inflammation
and the immune response.?
http://nic.sav.sk/logos/books/scientific/z.html
========================================
FUO - Fever of Unknown Origin
========================================
Periodic/Intermittent Fever
Recurrences of fever that last from a few days to a few weeks and are
separated by symptom-free intervals of varying duration. This pattern
of fever can be caused by recurrent infection, malignancy or
noninfectious inflammatory disorders.
http://www.medterms.com/script/main/art.asp?articlekey=19259
========================================
Blood Transfusion:
========================================
Did your brother receive any blood via transfusion?
Delayed hemolytic reactions to a blood transfusion can cause fevers.
?Delayed hemolytic reactions are generally mild in comparison. These
are caused by antibodies to non-D antigens of the Rh system or to
foreign alleles in other systems such as the Kell, Duffy or Kidd
antigens. Following a normal, compatible transfusion there is a 1-1.6%
chance of developing antibodies to these foreign antibodies. This
takes weeks or months to happen - and by that time, the original
transfused cells have already been cleared.
Re-exposure to the same foreign antigen can then cause an immune
response. Thus the reaction is typically delayed from two to
twenty-one days after transfusion.
Symptoms are generally mild and include malaise, jaundice, fever, a
fall in hematocrit despite transfusion, and an increase in
unconjugated bilirubin. Diagnosis may be facilitated by the direct
Coombs test which can detect the presence of antibodies on the
membranes of red cells.
Treatment is generally supportive. These reactions occur in
approximately 1 in 2,500 transfusions and most often in females with
previous exposure secondary to pregnancy.?
http://anesthesiologyinfo.com/articles/06232002.php
?Because fever (alone or accompanied by chills/rigors) may be the
first manifestation of a life-threatening reaction (e.g. acute
hemolysis, transfusion-associated sepsis, transfusion-related acute
lung injury), as well as, the more benign and common febrile
non-hemolytic transfusion reaction (FNHTR), any significant increase
in temperature (?1oC or 2oF) occurring during transfusion must be
taken seriously.?
http://www.itxm.org/TMU2002/Issue6.htm
Blood Borne Pathogens:
Malaria, Lyme Disease, Hepatitis B, C and G and TTV, HIV, CMV,
Leishmaniasis are among some organisms that can be acquired through
blood transfusions. This is not intended to alarm you, but offered as
a possibility. Keep in mind that contaminated donor blood is very
rare. While any of the above is a possibility, the probability is very
slim.
Has your brother traveled to areas where malaria is present? While not
probable, if he has traveled, or if he has had a transfusion, malaria
is a possibility. There have been instances of acquiring malaria
through a blood transfusion. We once had a patient die of malaria,
after a transfusion. The donor was traced, and according to what he
said, he had not traveled out of the country for 3 years prior to
donating!
?The number of transfusion associated cases of malaria, however, is at
an all-time high. There are no practical laboratory tests available to
test donor Blood, so donors travelling to high risk malaria areas are
often deferred from donating Blood for six months. This policy,
however, is not evenly applied in all areas and, believe it or not,
depends on the honor system to work.?
http://www.bloodbook.com/trans-tran.html
?Sometimes the disease is transmitted through blood transfusion or
from mother to fetus. Symptoms of malaria include fever, chills,
headaches, muscles aches, and malaise.?
http://www.georgiaencyclopedia.org/nge/Article.jsp?path=/ScienceMedicine/Medicine/ResearchandPublicHealth&id=h-2706
http://www.fpnotebook.com/ID122.htm
========================================
Ventriculoperitoneal shunt
========================================
?There may be accompanying fever and abdominal pain or discomfort. In
infection of ventriculo-atrial shunts, fever is present in most cases
though often intermittently.?
http://www.whitebuffalopress.com/hydro.htm
Shunt malfunctions & Fever
http://www.spina.qc.ca/en/hydrocephalie.htm#6
?The early symptoms of shunt malfunction or
infection are:
? Fever
? Vomiting
? Irritability and/or sleepiness?
http://www.ihc.com/xp/ihc/documents/pcmc/hydrocephalus.pdf
http://www.drkoop.com/ency/article/003019.htm
========================================
Additional Reading:
========================================
You may find this page, from the National Brain Tumor Foundation
interesting. Here is a chart of patients who had the same or similar
surgery as your brother, and their outcomes. The most interesting, to
me, is Kevin, found about half-way down the page. He was the fifth
human to ever receive gene therapy for his brain tumor. ?Has partial
paralysis on left side, mild memory issues Can't work, stays home w/
daughter.?
http://www.braintumor.org/pservices/patientnetwork.htm
Home Page
http://www.braintumor.org/index.html
Here is an interactive tour of the brain
http://www.braintumor.org/pservices/
Case history of a patient with skull fractures, fever and HO.
http://www.howardnations.com/braininjury/brain_demand_5.html
This article pertains to cardiac surgery, but it may be relevant reading.
?While many patients undergoing any type of surgery develop some
degree of hyperthermia within one to three days of surgery, Grocott
said that bypass patients tend to develop elevated temperatures much
sooner -- within eight to 10 hours after surgery. While the exact
cause of this hyperthermia is not clearly understood, the body's
inflammatory response to surgery itself, which is particularly
pronounced following bypass surgery, is likely involved, he said.?
http://www.scienceblog.com/community/older/2002/F/20022202.html
Alternatives to Dilantin - a previous Google Answer of mine:
http://www.answers.google.com/answers/threadview?id=404113
========================================
In summary, simon2342, many factors could be contributing to your
brother?s fever. We can effectively rule out infection from your
clarification. From my research, we conclude that brain surgery and
it?s disruption of the brain, can cause fever. Stroke can cause fever.
Drug sensitivities and heterotopic bone growth, not uncommon in stroke
patients, can cause fever, along with inflammation in general, or a
blood transfusion reaction (you did not say if he had had a
transfusion of any kind-blood or one or more of it?s components such
as RBCs, plasma, FFP (Fresh frozen plasma), cryoprecipitate, or
platelets. You may want to discuss with your brother?s health care
team the possibility of keeping your brother?s fever under control, as
it is delaying his recovery. The medical staff will be well aware of
effective cooling methods, be it anti-inflammatory medicines or a
water cooled mattress.
I wish you and your family all the best, and a speedy recovery to your
brother. If any part of my answer is unclear, I will be glad to assist
you further, before this answer is rated. Simply click on the Answer
Clarification button if you don?t understand any part of my answer.
Sincerely,
crabcakes
Search Terms
Anticonvulsant hypersensitivity syndrome
Hyperthermia + brain injury
Intermittent fever
Periodic fever
pyrexia
FUO + neurocytoma
FUO
Fever of unknown origin
FUO + brain tumor
fever following brain tumor excision
Ventriculoperitoneal shunt |
