Bromocriptine and its Antipyretic Effect in Central Hyperthermia

Abstract

Central hyperthermia is marked by rapid onset of elevated temperatures, resistant to antibiotics and antipyretics. Diagnosis requires exclusion of infectious sources and identification of an underlying neurological condition. As it is linked to poor prognosis, early intervention is critical. Therapeutic options for temperature control are limited, with few supported by strong clinical evidence. Bromocriptine, which modulates dopaminergic transmission, has been used in some cases, although its use remains off-label and based on limited case reports.

The case involves a 72-year-old male with traumatic brain injury, including an acute subdural hematoma and subarachnoid hemorrhage. Hyperthermia refractory to antipyretics developed within 24 hours. After ruling out infection, central hyperthermia was diagnosed. Bromocriptine was initiated and titrated, leading to sustained temperature control after 72 hours. Upon discontinuation, hyperthermia recurred but resolved with reintroduction of bromocriptine. This case highlights the complexity of central hyperthermia management, suggesting bromocriptine may offer benefit despite limited evidence.