A Case of Suspected Neuroleptic Malignant Syndrome Caused by Discontinuing Psychotropic Drug, with Difficulty of Inspection of Thermal Source

Abstract

 The patient was a 26-year-old male. He was undergoing medical treatment for depression and dissociative disorder. He had flame burn and was transported to our hospital. On the first day, he had a fever in the 39℃ range and an elevated inflammatory response. We did not suspect a wound infection; therefore, we performed standby surgery. After several days of treatment with antibiotics, the patient underwent surgery on the 7th day, but the fever did not resolve. The fever resolved on the 17th day, and the patient remained fever-free thereafter. When the source of the fever was retrospectively examined, the psychotropic medication he had been taking had been discontinued after his admission. Neuroleptic malignant syndrome caused by the discontinuation of psychotropic medication was suspected. In burn treatment, it is important to pay attention to fever caused by wound infection. However, because of the variety of causes of severe burns, all possibilities should be considered. In addition, since burn treatment often involves multiple departments, close information sharing is necessary.