Neurological fevers?

[SnowbirdRN]

I'm a high-tech pediatric visiting nurse and most of the kids I work with have had severe anoxic brain injury. For one it happened 18 years ago when she was a premie and coded, another 5yr old drowned when she was 18mo. With both these kids I've experienced "neurological fevers". I'm not sure on the background of this or what not. Basically the kids occasionally get fevers(usually 99-101.5) without getting sick. Should I treat the fevers? I usually do if they look uncomfortable.

I've heard of fevers in the acute phase of TBI but not several years after the event.

The 5yr old had bilat hip surgery last weds (it's monday now) and had a temp of 101 today. I know it's common for a low fever after major surgery but 5 days after? Incisions look good and I don't see any signs of infection. I'm not sure if the temp was normal post-op related, neurological, or if I should be concerned(She's also been taking acetaminophen with codeine every 4 hrs so I would think there wouldn't be a temp while on that! I wonder how much higher it would be if she weren't taking it).

Also, the poor kid peed all over her spica casts. They're soaked. Mom is calling the surgeon tomorrow. I suggested a blow dryer on low for now but dry pee is nearly just as bad isn't it? Sure smells lovely.

[neurorn6]

I don't want to assume, so how did you take the temp? Rectal, tympanic? You're correct in regards to frequent neuro temps, but I'm concerned with the temp 5 days out from surgery. How were the rest of the vs? Best opinion at this point is to speak with the surgeon. She could be "cooking" an infection. Nothing for the urine smell. Sorry.

Hope she does well.

[SnowbirdRN]

i did both axillary and oral temps. HR was elevated (110-20ish) RR 28, which is her norm.

I told the parents to mention the temp to the surgeon when they call about the casts.

Do you understand the basis of neurological fevers?

If they decide to keep the same casts, i might put some toothpaste on it or something.

[neurorn6]

I've spoken to different neurosurgeon that I have worked with regarding a neuro fevers. The best way I can explain it is that can be related to damage to the hypothalmus or it can be a metabolic inbalance.

Everyone of them had a different take on why they occur. I wonder if they really know themselves. I know that's not much help but that's about all I can tell you. Hope things are going well.