Fever and infection early after ischemic stroke

Previous studies showed that elevated body temperature early after ischemic stroke is associated with severe neurological deficit and a poor outcome. The aim of this study was to analyse the prevalence and putative etiology o f febrile body temperature (greater than or equal to 38.0 degrees C) early after stroke and to investigate the association between body temperature, s troke severity and outcome. We investigated 119 consecutive patients who we re admitted within 24 h after ischemic stroke. Patients were examined for i nfection before ischemia using a standardized questionnaire and received da ily clinical examination after stroke. In case of fever, standardized radio logical and microbiological examinations were performed. Fever within 48 h after stroke was observed in 30 (25.2%) patients. The probable cause of fev er was infective or chemical aspiration pneumonia (n=12), other respiratory tract infection (n=7), urinary tract infection (n=4), viral infections (n= 3) or insufficiently defined (n=5). (One patient had two potential causes o f fever.) In thirteen of these patients, infection was most probably acquir ed before stroke. Fever newly developed more often during day 1 to 2 than d ay 3 to 7 after stroke (P=0.016). Fever was associated with a more severe d eficit on admission independent from age, vascular diseases and risk factor s (odds ratio 9.6; 95% confidence interval 3.1-29). Fever is a frequent com plication early after stroke and in the majority of cases, it can be explai ned by infection or chemical aspiration pneumonia. In about half of the inf ected patients, infection was most probably acquired before stroke. Fever w as associated with a more severe neurological deficit on admission. (C) 199 9 Elsevier Science B.V. All rights reserved.