Fever and infection influence TBI outcomes. Which statements describe fever-management strategies?

• A. Fever worsens metabolic demand and injury; treat with antipyretics, cooling measures, and infection prevention
• B. Fever is protective and should not be treated
• C. Fever management is unnecessary in TBI
• D. Antibiotics alone resolve fever without other measures

Answer: (A)

Fever after a traumatic brain injury raises the brain’s metabolic demand and can worsen secondary brain injury, so controlling temperature is a critical part of managing these patients. Reducing fever helps limit the extra energy the brain must use and can help protect neural tissue during a period when oxygen and perfusion are already vulnerable.

Treating fever with antipyretics such as acetaminophen helps lower body temperature and decreases cerebral metabolic rate. When fevers persist or are high, cooling measures—like external cooling devices or, in some centers, controlled intravascular cooling—can further help maintain normothermia and reduce metabolic stress on the injured brain. Preventing and promptly addressing infection is also essential because infectious processes are a common cause of fever in hospitalized patients with TBI; good infection prevention and, when indicated, appropriate treatment help minimize fever-related insults.

Other statements are not consistent with how fever is managed in TBI. Fever being protective and not needing treatment contradicts evidence that fever worsens metabolic stress. Claiming fever management is unnecessary ignores the ongoing risk to brain tissue from elevated temperatures. And antibiotics alone don’t resolve fever without addressing the fever’s source and, when present, implementing temperature-reduction strategies and infection control.