QUAD fever: beware of non-infectious fever in high spinal cord injuries

  • rachna
  • Jun 23, 2017
  • 0 Comment(s)

by – Jyoti Goyal, Rakesh Jha, Paramjeet Bhatia, Raj Kumar Mani


A case of cervical spinal cord injury and quadriparesis
with prolonged fever is being described. Initially,
the patient received treatment for well-documented
catheter-related bloodstream infection. High spiking
fever returned and persisted with no obvious evidence
of infection.
The usual non-infectious causes too were
carefully excluded. QUAD fever or fever due to spinal
cord injury itself was considered. The pathogenetic basis
of QUAD fever is unclear but could be attributed to
autonomic dysfunction and temperature dysregulation.
Awareness of this little known condition could help
in avoiding unnecessary antimicrobial therapy and in
more accurate prognostication. Unlike several previous
reported cases that ended fatally, the present case ran a
relatively benign course. The spectrum of presentations
may therefore be broader than hitherto appreciated.




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