ArticleJournal of anesthesia2026
Fatal hyperthermia triggered by drug-induced fever in a patient with high-level spinal cord injury: a case report.
Article in Journal of anesthesia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
We report a rare fatal hyperthermic crisis likely precipitated by drug-induced fever in a muscular, obese patient with chronic high-level spinal cord injury (SCI). Shortly after antibiotic therapy was changed to meropenem, the patient developed severe agitation and hyperthermia exceeding 41 °C, accompanied by autonomic instability. Despite intensive management, including active cooling, intravenous fluids, and vasoactive support, the core temperature remained above 41 °C. Computed tomography revealed a low-density brainstem lesion consistent with infarction. The patient experienced respiratory arrest and died 4 h after admission to the ICU. This case underscores the complex interplay between drug-induced fever, impaired thermoregulation due to SCI, and heat-retentive body composition. This case highlights the risk of rapid and disproportionate temperature elevation in patients with high-level SCI, even in response to relatively minor fever-provoking stimuli, due to impaired thermoregulation. Early recognition and prompt intervention are crucial to prevent fatal hyperthermic crises in this vulnerable population.
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