INTRODUCTION
Hyperthermia is a prevalent occurrence, affecting nearly 70% of
neuro-critically ill patients who are admitted with traumatic brain
injury (TBI), subarachnoid hemorrhage (SAH), and intracerebral
hemorrhage (ICH). Among these cases, half are attributed to
noninfectious causes but are frequently misdiagnosed and managed as
infectious fever, leading to unwarranted use of antibiotics,
antimicrobial resistance, adverse drug reactions, increased treatment
costs, and extended hospital stays.1, 2
The temperature elevation associated with neurogenic fever is notably
high and often resistant to antipyretic medications, necessitating
prompt and aggressive treatment to prevent secondary brain
injury.3 In addition to external cooling
methods, appropriate drug therapy is crucial. However, the lack of
clinical practice guidelines for treating central hyperpyrexia leaves a
knowledge gap. A multi-modal approach involving propranolol, baclofen,
amantadine, bromocriptine, and intravascular cooling has been
recommended. This case report describes a successful treatment of severe
traumatic brain injury with neurogenic fever using a combination of
baclofen and propranolol.