Fever in the wake of a stroke

Area of Science:

• Neurology
• Infectious Diseases
• Pulmonology

Background:

• Fever is a common complication following stroke.
• The source of fever in stroke patients is often unclear.
• Distinguishing stroke-related fever from other causes is crucial for appropriate management.

Purpose of the Study:

• To determine the frequency and causes of fever in adult patients following a non-traumatic stroke.
• To investigate the association between stroke type and fever development.
• To differentiate fever causes in the early post-stroke period.

Main Methods:

• Prospective study design.
• Inclusion of 104 consecutive adult patients admitted for non-traumatic stroke.
• Definition of fever as rectal temperature >= 101°F within 5 days post-stroke.
• Identification and attribution of fever sources.

Main Results:

• Fever occurred in 23% of stroke patients.
• A source was identified in 19 patients, with 13 cases attributed to pulmonary insults (pneumonia or chemical pneumonitis).
• Patients with lacunar infarcts did not develop fever.

Conclusions:

• Fever following stroke is frequently linked to pulmonary inflammation, not the cerebrovascular event itself.
• Pulmonary causes, such as pneumonia, should be prioritized when evaluating fever post-stroke.
• The absence of fever in lacunar infarcts suggests a different pathophysiology or risk profile.