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Case Report

Sudan J Paed. 2021; 21(2): 205-208

Hypothermia induced by therapeutic doses of antipyretics: misdiagnosis of cold sepsis

Indranil Dey, Natasha Singhal, Hannah Ruth Walsh, Paul Anthony Heaton, Siba Prosad Paul.


Fever is a natural and almost universal mammalian response to infection. There exists a fear amongst general public and healthcare
providers regarding fever being harmful leading to its overzealous management with antipyretics. Although the National Institute for Health and
Care Excellence (NICE) guidelines suggest the use of single antipyretic agent for management of fever, combination therapy with paracetamol,
and ibuprofen is common in paediatric practice in the United Kingdom. These antipyretics at times can cause significant adverse events even when
administered at regular therapeutic doses. We describe a young boy who presented with significant hypothermia (34.1°C) and was initially
treated as cold sepsis. Once the boy got warmed up and as blood results became subsequently available, it became clearer that the hypothermia
was secondary to therapeutic doses of antipyretics. In conclusion, we hope to improve awareness regarding this condition in clinical practice and
educate health care professionals and caregivers with recommended NICE guidelines.

Key words: Fever; hypothermia; antipyretics; therapeutic doses; sepsis.

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