Occult maxillary sinusitis as a cause of fever in tetraplegia: 2 case reports

Henry L. Lew, Jay Han, Lawrence R. Robinson, Catherine Britell, Inder Perkash

Research output: Contribution to journalArticlepeer-review


Common causes of fever in tetraplegia include urinary tract infection, respiratory complications, bacteremia, impaired autoregulation, deep vein thrombosis, osteomyelitis, drug fever, and intra-abdominal abscess. We report 2 acute tetraplegic patients who presented with fever of unknown origin. After extensive work-up, they were diagnosed with occult maxillary sinusitis. A search of current literature revealed no reports of sinusitis as a potential source of fever in recently spinal cord-injured patients. Patients with tetraplegia, especially in the acute phase of spinal cord injury, often undergo nasotracheal intubation or nasogastric tube placement, which may result in mucosal irritation and nasal congestion. All of the previously mentioned factors, in combination with poor sinus drainage related to supine position, predispose them to developing maxillary sinusitis. The 2 consecutive cases show the importance of occult sinusitis in the differential diagnosis of fever in patients with tetraplegia.

Original languageEnglish (US)
Pages (from-to)430-432
Number of pages3
JournalArchives of Physical Medicine and Rehabilitation
Issue number3
StatePublished - 2002
Externally publishedYes


  • Case report
  • Fever
  • Nosocomial infections
  • Rehabilitation
  • Sinusitis
  • Spinal cord injury
  • Tetraplegia

ASJC Scopus subject areas

  • Rehabilitation


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