Fever can be found in patients diagnosed with cerebrovascular diseases (CVD) and may affect the outcome of patients. Fever from CVD itself depends on the type and affected area. It is difficult to differentiate fever that caused by CVD and infection.
A prospective study was conducted at Chiang Mai University Hospital among patients aged ≥ 18 years diagnosed with CVD between July 1, 2013 and June 30, 2014. Comparisons between groups were performed using Chi-square or Fisher’s exact test, or Student’s t-test or Mann-Whitney U test as appropriate.
Three hundred and sixty-one consecutive patients were enrolled, 182 patients were male (50.4%) and the median age was 65 years (IQR 54, 76). Of these, 279 and 82 patients had cerebral infarction and cerebral hemorrhage, respectively. Eighty-nine patients had fever giving an incidence of fever of 24.6 %, 61among patients with cerebral infarction (21.9 %) and 28 among patients with cerebral hemorrhage (34.2%). (p=0.023) Multivariate analysis showed factors associated with fever among patients with CVD included female (OR 2.2, 95% CI 1.18, 4.15, p=0.014), age ≥70 years (OR 2.86, 95% CI 1.51, 5.41,p=0.001), and white blood cell count ≥ 10,000 cells/mm3 (OR 3.55, 95% CI 1.86, 6.78, p<0.001). Patients who had lacunar infarction were unlikely to have fever (OR 0.4, 95% CI 0.18, 0.89, p=0.025). Among those who had fever, 77 (86.5%) and 12 (13.5%) patients had and had no documented source of infection, respectively.
The incidence of fever among patients with CVD was not uncommon. Fever among these patients should be investigated as undocumented source of fever was found only in minority of patients, particularly among patients with lacunar infarction.