What causes a coma due to high fever?

High fever usually refers to high body temperature. Generally, high fever and unconsciousness may be caused by dysfunction of the thermoregulatory center, insufficient cerebral perfusion, sepsis, tuberculous meningitis, toxic encephalopathy, and other conditions. If these symptoms occur, immediate medical attention is recommended. Detailed explanations are as follows:

1. Dysfunction of the Thermoregulatory Center

External stimuli may cause dysfunction of the body's thermoregulatory center, leading to an imbalance between heat production and dissipation, which results in high fever. Severe cases may affect brain function and lead to coma. Immediate removal from the stimulating environment is necessary, along with physical cooling methods such as applying ice packs to the forehead. Body temperature should be monitored every 30 minutes.

2. Insufficient Cerebral Perfusion

Low blood pressure, blood loss, or other factors can lead to insufficient cerebral perfusion, causing cerebral ischemia and hypoxia, which results in functional impairment. Simultaneously, the body's stress response increases heat production, leading to high fever, which may be accompanied by pallor. The patient should immediately lie down with the lower limbs elevated to increase cerebral blood supply. Prompt volume replacement is necessary, and intravenous administration of balanced fluids, dextran 40 glucose injection, or other treatments may be required to improve circulation.

3. Sepsis

Bacterial infection may lead to sepsis, with a systemic inflammatory response causing high fever. Toxins can damage the brain, resulting in coma, often accompanied by tachycardia and hypotension. Under a physician's guidance, patients may require antibiotics such as piperacillin sodium-tazobactam sodium for injection, ceftazidime for injection, or levofloxacin injection to control the infection.

4. Tuberculous Meningitis

Infection of the meninges by Mycobacterium tuberculosis leads to an inflammatory response causing high fever. Increased intracranial pressure and brain tissue damage can result in coma, possibly accompanied by night sweats and nuchal rigidity. Under a physician's guidance, anti-tuberculosis treatment may include isoniazid injection, rifampicin injection, and pyrazinamide tablets.

5. Toxic Encephalopathy

Infections or toxins may cause toxic encephalopathy, with brain tissue edema and metabolic disturbances leading to high fever and coma. Symptoms may include seizures and abnormal respiration. Under a physician's guidance, medications such as mannitol injection, dexamethasone injection, and cytidine diphosphate-choline sodium for injection may be used to reduce cerebral edema and protect brain tissue.

In daily life, it is important to actively treat underlying diseases to prevent worsening infections, avoid exposure to toxic substances to prevent poisoning, and promptly manage fever to avoid excessively high temperatures. If high fever and coma occur suddenly, emergency medical services should be contacted immediately. While waiting for assistance, ensure airway patency.