Effectively managing intractable central hyperthermia in a stroke patient by bromocriptine: a case report

Kuo-Wei Yu,^1,* Yu-Hui Huang,^2,3 Chien-Lin Lin,^1,4,* Chang-Zern Hong,⁵ Li-Wei Chou<sup>1,4

1</sup>Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan; ²School of Medicine, Chung Shan Medical University, Taichung, Taiwan; ³Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital, Taichung, Taiwan; ⁴School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; ⁵Department of Physical Therapy, Hungkuang University, Taichung, Taiwan

*These authors contributed equally to this work

Abstract: Central hyperthermia is characterized by a rapid onset, high temperature, marked temperature fluctuation, and poor response to antipyretics and antibiotics. Although poststroke central hyperthermia is common, prolonged instances are rare. We report a case of prolonged central fever after an intracranial hemorrhage. Before the accurate diagnosis and management of central fever, the patient underwent long-term antibiotic use that led to pseudomembranous colitis. Bromocriptine was used to treat the prolonged central hyperthermia, after which the fever did not exceed 39°C. A week later, the body temperature baseline was reduced to 37°C and a low-grade fever with minor temperature fluctuation occurred only a few times. No fever occurred in the month following the treatment. After the fever subsided, the patient could undergo an aggressive rehabilitation program.

Keywords: bromocriptine, central hyperthermia, fever, stroke