From the Research
Pneumonia can lead to rigor through the body's inflammatory response to infection, which triggers the release of pyrogens affecting the hypothalamus and causing muscle contractions as the body attempts to generate heat. When bacteria, viruses, or other pathogens invade the lungs, they trigger this response, leading to vasoconstriction and muscle contractions that manifest as rigors or shaking chills, typically occurring during the rapid rise in body temperature 1. The severity of rigors often correlates with the intensity of the infection and the body's immune response. Pneumonia-associated rigors are particularly common with bacterial pneumonias, especially those caused by Streptococcus pneumoniae, Klebsiella, or Staphylococcus aureus.
Key Points to Consider
- The presence of rigors in pneumonia patients may indicate a more severe infection or bacteremia (bacteria in the bloodstream) 2.
- Treatment focuses on addressing the underlying pneumonia with appropriate antibiotics, such as those recommended for severe CAP, NP, and septicemia, including cefepime, imipenem, meropenem, and piperacillin-tazobactam 2.
- Antipyretics like acetaminophen or ibuprofen can be used to manage fever, and supportive care including adequate hydration and rest is crucial 3.
- Early appropriate initial antibiotic therapy is essential in reducing the length of intensive care unit stay and the risk of mortality in patients with hospital-acquired pneumonia and ventilator-associated pneumonia 4.
Recommendations
- Early initiation of appropriate antibiotic therapy is critical in managing pneumonia and preventing complications such as rigor.
- The choice of antibiotic should be guided by local and national resistance data, and should cover a broad spectrum of Gram-negative and Gram-positive bacteria, including Pseudomonas aeruginosa 2.
- Combination therapy with an anti-pseudomonal beta-lactam and a fluoroquinolone or an aminoglycoside may be recommended for patients with severe pneumonia or septicemia and risk factors such as underlying diseases, antibiotic pretreatment, or mechanical ventilation 2.