From the Guidelines
Treatment for pyrexia and facial edema should begin with antipyretics such as acetaminophen and/or NSAIDs, and may require discontinuation or dose reduction of certain medications, such as BRAF/MEK inhibitors.
Causes of Pyrexia and Facial Edema
- Pyrexia and facial edema can be caused by various conditions, including infections, autoimmune disorders, and side effects of certain medications, such as BRAF-targeted therapy 1.
- In the context of COVID-19, pyrexia and facial edema can be symptoms of COVID-19-associated mucormycosis (CAM), a rare but serious fungal infection 1.
Treatment Options
- For pyrexia associated with BRAF-targeted therapy, treatment discontinuation and use of antipyretics such as acetaminophen and/or NSAIDs are recommended 1.
- For CAM, treatment options include antifungal medications, such as echinocandins, and surgical intervention may be necessary in some cases 1.
- For superficial infections, such as cellulitis and erysipelas, antibiotic therapy against Gram-positive bacteria is recommended, and may include oral beta-lactams, macrolides, or lincosamides 1.
Important Considerations
- Patients treated with BRAF-targeted therapy should be educated to report joint pain and swelling, visual changes, and cutaneous manifestations, and should be advised about the possibility of photosensitivity associated with these agents 1.
- In the context of COVID-19, patients with diabetes mellitus, steroid use, and severe COVID-19 are at higher risk of developing CAM, and zinc therapy may be protective 1.
From the Research
Treatment Options for Pyrexia and Facial Edema
The treatment for pyrexia and facial edema can vary depending on the underlying cause. Some possible treatment options include:
- Corticosteroids, which have been shown to be effective in treating facial edema associated with conditions such as dermatomyositis 2 and Melkersson-Rosenthal syndrome 3
- Antibiotics, which may be used in cases where facial edema is caused by an infection 2
- Pulsed-dye laser (PDL) therapy, which has been used to treat facial hypervascularity and edema 4
- Lymphovenous anastomosis (LVA), a surgical procedure that can help to alleviate severe facial lymphedema 5
- Intralesional injections of triamcinolone acetonide or betamethasone, which can be used to treat oro-facial edema in conditions such as Melkersson-Rosenthal syndrome 3
Diagnostic Approach
A proper diagnostic approach is essential to determine the underlying cause of pyrexia and facial edema, and to prescribe a targeted treatment 6. This may involve a range of tests and investigations, including laboratory tests, imaging studies, and biopsies.
Specific Conditions
In some cases, pyrexia and facial edema may be symptoms of a specific condition, such as:
- Dermatomyositis, a condition that can cause facial edema and pyrexia, and which may require treatment with corticosteroids 2
- Melkersson-Rosenthal syndrome, a rare disorder that can cause oro-facial edema, facial nerve palsy, and furrowing of the tongue, and which may require treatment with corticosteroids and other medications 3
- Facial hypervascularity, a condition that can cause erythema and edema, and which may be treated with PDL therapy 4