Fever during alcohol withdrawal syndrome

      Abstract

      Background: Fever is considered common during alcohol withdrawal, but there are very few reports focused on this problem. The aim of the present study was to evaluate the prevalence and causes of fever in patients admitted to the hospital with alcohol withdrawal syndrome. Methods: A total of 110 episodes of alcohol abstinence syndrome (10 cases of tremulousness and anxiety, 38 of delirium, and 62 cases of seizure) in 98 patients admitted to the hospital for that reason (82 males and 12 females, median age 42 years, range 18–72 years) were reviewed. Cases with fever on admission were not included. Results: Seventy-two cases (65%) presented low-grade fever (maximum axillary temperature 37–37.9°C), and 23 cases (21%) presented high-grade fever (≥38°C). Pyrexia appeared after a median of 2 days in the hospital (range 1–8 days). The prevalence of fever was similar among the different alcohol withdrawal syndromes. Catheter-associated phlebitis was the cause of pyrexia in 39 cases (41%). Respiratory infection was present in 15 cases of pyrexia (16%) and urinary tract infection in 11 (12%). Patients with low serum albumin levels had a higher rate of both respiratory and urinary tract infection. Ten patients (12%) had more than one cause of fever. In 38 cases of pyrexia (40%), no cause was identified. This was more frequent in low-grade fever (33 cases, 46%) than in high-grade fever (five cases, 22%). All cases of pyrexia without an obvious cause resolved spontaneously after a median of 3 days. Conclusions: Pyrexia is very common during alcohol withdrawal syndrome. A cause may frequently be identified, particularly in patients with high-grade fever. Many patients have transient pyrexia (mostly low-grade fever) without an obvious cause.

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