From the Guidelines
Yes, pleurodesis can cause fever as a common side effect, with a reported incidence of 16 to 69% of patients, as noted in the study by 1. Fever typically develops within 4-12 hours after the procedure and may last for 1-3 days. Temperatures can range from low-grade (99-100.5°F or 37.2-38°C) to more significant fevers (up to 102-103°F or 38.9-39.4°C). This fever response occurs because pleurodesis intentionally creates inflammation between the pleural layers to make them adhere together, and this inflammatory process triggers the release of cytokines and other inflammatory mediators that affect the body's temperature regulation. Some key points to consider when managing fever after pleurodesis include:
- Patients undergoing pleurodesis are often given antipyretics like acetaminophen (650-1000mg every 6 hours as needed) to manage fever symptoms.
- It's essential to note that while fever is expected, persistent high fever beyond 3-4 days or fever accompanied by increasing pain, shortness of breath, or purulent drainage may indicate an infection rather than a normal inflammatory response and should prompt medical evaluation.
- Most pleurodesis-related fevers resolve spontaneously with supportive care and do not require specific treatment beyond standard antipyretics, as supported by the guidelines outlined in 1 and 1. The most recent and highest quality study, 1, published in 2018, provides valuable insights into the management of malignant pleural effusions, including the use of talc pleurodesis and its associated side effects, such as fever. Overall, the development of fever after pleurodesis is a common and generally self-limiting side effect, but it requires careful monitoring and management to prevent potential complications, as emphasized in the studies by 1, 1, and 1.
From the Research
Pleurodesis and Fever
- Pleurodesis is a procedure that aims to obliterate the pleural space by producing extensive adhesion of the visceral and parietal pleura, and it can be associated with various complications, including fever 2.
- The use of talc as a sclerosing agent in pleurodesis can cause an inflammatory response, which may lead to fever as a complication 2, 3.
- A study on the long-term effect and tolerance of talc slurry for control of malignant pleural effusions found that complications related to talc, including fever, were rare and moderate 2.
- Another study on the mechanisms of pleurodesis discussed the potential for systemic inflammation and activation of the coagulation cascade as complications of pleurodesis, which may also include fever 4.
- The exact mechanism of pleurodesis is not completely understood, and there is still controversy surrounding the procedure, including its potential to cause fever and other complications 5.