Neuroleptic malignant syndrome (NMS) is a rare but sometimes fatal reaction to drugs that a patient is given for psychotic conditions, delirium, or nausea and vomiting. The symptoms of NMS are fever, muscle stiffness, confusion, loss of control of body functions, and an increase in white blood cell count. A delirious patient who does not improve when treated with medication should be examined for NMS. Treatment for NMS includes stopping the drug, treating the symptoms, and sometimes using other drugs. (Refer to the PDQ summary on Cognitive Disorders and Delirium for more information.)
Cancer patients may develop a fever as a reaction to blood products (for example, receiving a blood transfusion). Removing white blood cells from the blood or treating the blood product with radiation before transfusing it into the patient can lessen the reaction. The possibility of fever due to receiving blood products can also be lessened by giving patients acetaminophen or antihistamines before the transfusion.
General Treatments to Relieve Fever
Along with treatment of the underlying cause of fever, comfort measures may also be helpful in relieving the discomfort that goes along with fever, chills, and sweats. During periods of fever, giving the patient plenty of liquids, removing excess clothing and linens, and bathing or sponging the patient with lukewarm water may give relief. During periods of chills, replace wet blankets with warm, dry blankets, keep the patient away from drafts, and adjust the room temperature to improve patient comfort.
Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen may also be prescribed to relieve symptoms. Aspirin may be effective in decreasing fever, but should be used with caution in patients with Hodgkin lymphoma and cancer patients who are at risk for developing a decrease in the number of platelets in the blood. Aspirin is not recommended in children with fever because of the risk of developing Reye syndrome.