Managing Fever in Patients with Pericarditis

When patients with pericarditis experience fever, the primary goal of treatment is not simply to reduce body temperature. Instead, a comprehensive evaluation of the severity of the fever and the underlying cause of the pericarditis is necessary before determining the appropriate course of treatment. The etiology of pericarditis can be categorized into several distinct types, each requiring a tailored approach:

Rheumatic Fever

Pericarditis caused by rheumatic fever is typically managed with analgesics and anti-inflammatory medications. In cases of purulent pericarditis where body temperature exceeds 38°C or 38.5°C, antipyretic therapy may be introduced. However, if the fever remains at a low grade, specific antipyretic treatment is usually avoided. The focus in such cases is primarily on anti-infective and antimicrobial therapy to address the root cause.

Tuberculosis

In cases of tuberculous pericarditis, the standard approach involves initiating anti-tuberculosis therapy. Antipyretic treatment is generally reserved for patients with significant fever. If the temperature elevation is mild, fever-reducing medications are typically not required, as the priority remains treating the underlying infection.

Non-Specific Pericarditis

For non-specific forms of pericarditis, identifying and addressing the underlying trigger is essential. Treatment focuses on resolving the root cause rather than simply managing symptoms.

The Role of Antipyretic Therapy

Antipyretic treatment should be viewed as a supportive, symptomatic measure rather than a primary intervention. Not all febrile episodes in pericarditis patients require fever-reducing medication. Clinical judgment must guide the decision to use antipyretics, with emphasis placed on diagnosing and treating the underlying condition responsible for both the pericarditis and associated fever.