INTRODUCTION
Hyperthermia is a prevalent occurrence, affecting nearly 70% of neuro-critically ill patients who are admitted with traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), and intracerebral hemorrhage (ICH). Among these cases, half are attributed to noninfectious causes but are frequently misdiagnosed and managed as infectious fever, leading to unwarranted use of antibiotics, antimicrobial resistance, adverse drug reactions, increased treatment costs, and extended hospital stays.1, 2
The temperature elevation associated with neurogenic fever is notably high and often resistant to antipyretic medications, necessitating prompt and aggressive treatment to prevent secondary brain injury.3 In addition to external cooling methods, appropriate drug therapy is crucial. However, the lack of clinical practice guidelines for treating central hyperpyrexia leaves a knowledge gap. A multi-modal approach involving propranolol, baclofen, amantadine, bromocriptine, and intravascular cooling has been recommended. This case report describes a successful treatment of severe traumatic brain injury with neurogenic fever using a combination of baclofen and propranolol.