INTRODUCTION Elevation in body temperature within the first 24 hours of ischemic stroke is fairly common and known to be associated with worse outcomes. Only after thoroughly ruling out infection and the noninfectious etiologies and in the appropriate clinical setting should the diagnosis of central fever be made. Acetaminophen and nonsteroidal anti-inflammatory drugs are typical therapeutic options. External cooling is frequently used when pharmacologic interventions are inadequate. However, reports have suggested that neurogenic fevers are somewhat resistant to traditional pharmacologic therapies. CASE PRESENTATION We describe a case of a Caucasian patient with central fever after ischemic stroke not responsive to acetaminophen administration and external cooling. After an initial bolus of diclofenac sodium (0.2 mg/kg in 100 ml of saline solution for 30 minutes), a continuous infusion (75 mg in 50 ml of saline solution) was started. After 5 days of treatment, the patient's body temperature was below 37.5 °C, and the diclofenac sodium infusion was stopped. CONCLUSIONS We observed that a low-dose diclofenac sodium infusion was effective in treating fever without systemic side effects. This treatment may be suggested as an alternative to conventional antipyretic drugs, but additional clinical trials are required.

中文翻译：

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重症监护病房在缺血性中风后连续静脉注射小剂量双氯芬酸钠以控制中枢发热：一例病例并文献复习。

简介缺血性中风的前24小时内体温升高是相当普遍的现象，并且已知与较差的预后有关。仅在彻底排除感染和非感染性病因后，并在适当的临床环境中，才能做出中枢发热的诊断。对乙酰氨基酚和非甾体抗炎药是典型的治疗选择。当药理干预措施不足时，经常使用外部冷却。但是，有报道表明神经源性发烧对传统药物疗法有一定的抵抗力。病例介绍我们描述了一个白人患者，它在缺血性中风后对对乙酰氨基酚给药和外部冷却无反应。初次推注双氯芬酸钠后（0。在100毫升盐溶液中以2 mg / kg的剂量浸泡30分钟），开始连续输液（在50毫升盐溶液中为75毫克）。治疗5天后，患者体温低于37.5°C，并停止了双氯芬酸钠输注。结论我们观察到小剂量双氯芬酸钠输注可有效治疗发烧而无全身性副作用。可以建议使用这种治疗方法来替代传统的退热药，但还需要进行其他临床试验。结论我们观察到小剂量双氯芬酸钠输注可有效治疗发烧而无全身性副作用。可以建议使用这种治疗方法来替代传统的退热药，但还需要进行其他临床试验。结论我们观察到小剂量双氯芬酸钠输注可有效治疗发烧而无全身性副作用。可以建议使用这种治疗方法来替代传统的退热药，但还需要进行其他临床试验。