QUAD fever: beware of non-infectious fever in high spinal cord injuries

The case report describes a patient with a cervical spinal cord injury who experienced prolonged fever. After ruling out common causes like infection, the fever was attributed to the spinal cord injury itself, a condition known as QUAD fever. QUAD fever is believed to be caused by autonomic dysfunction and temperature dysregulation following a spinal cord injury. Recognizing this condition can help prevent unnecessary antibiotic use. Unlike previous cases with fatal outcomes, this patient had a relatively benign course, suggesting that QUAD fever may have a broader range of presentations than previously thought.

• 1
  QUAD fever should be considered in patients with high spinal cord injuries who present with fever and when other causes have been excluded.
• 2
  The case highlights the importance of excluding infectious and non-infectious causes of fever before diagnosing QUAD fever.
• 3
  Procalcitonin may be a reliable marker to exclude bacterial infection in cases of suspected QUAD fever.