Rigor

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Shaking chills

Overview

Rigor is a shaking occurring during a high fever. It occurs because cytokines and prostaglandins are released as part of an immune response and increase the set point for body temperature in the hypothalamus.

The increased set point causes the body temperature to rise (pyrexia), but also makes the patient feel cold until the new set point is reached. Rigor occurs because the patient is effectively shivering in a physiological attempt to increase body temperature to the new set point.

Causes

Common Causes

Acute cholangitis Amphotericin B Anti-TNF alpha drugs Biliary sepsis Brucellosis Catheterization Dressler's syndrome Filariasis Gastroenteritis Generalized pustular psoriasis Gentamicin Hemodialysis Infective endocarditis Influenza Interleukin II Jarisch-Herxheimer reaction Lemierre's syndrome Louse-borne relapsing fever Lyme disease Malaria Meningitis

Meningococcal septicemia Normal vaginal delvery Pericarditis Pneumonia Post bone marrow transplant Post operative infections Post radiotherapy Prostate cancer Prostatitis Pyelonephritis Rat bite fever Rheumatic fever Septic arthritis Sepsis Severe acute respiratory syndrome Severe generalized rash Transfusion reaction Tonsillitis Tuberculosis Ulcerative colitis Urinary tract infections Vancomycin Visceral abscess

Causes by Organ System

Cardiovascular	No underlying causes
Chemical / poisoning	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	Agalsidase beta, Denileukin diftitox, Doxorubicin Hydrochloride, Imiglucerase, Ixabepilone, Meropenem, Panitumumab, Pergolide, Pramipexole, Ramucirumab, Sargramostim, Sipuleucel-T, Teniposide, Tiagabine, Voriconazole, Zanamivir
Ear Nose Throat	No underlying causes
Endocrine	No underlying causes
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	No underlying causes
Hematologic	No underlying causes
Iatrogenic	No underlying causes
Infectious Disease	No underlying causes
Musculoskeletal / Ortho	No underlying causes
Neurologic	No underlying causes
Nutritional / Metabolic	No underlying causes
Obstetric/Gynecologic	No underlying causes
Oncologic	No underlying causes
Opthalmologic	No underlying causes
Overdose / Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	No underlying causes
Renal / Electrolyte	No underlying causes
Rheum / Immune / Allergy	No underlying causes
Sexual	No underlying causes
Trauma	No underlying causes
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	No underlying causes

Causes in Alphabetical Order

• Doxorubicin Hydrochloride
• Ixabepilone
• Panitumumab
• Pergolide
• Ramucirumab
• Sargramostim
• Sipuleucel-T
• Teniposide
• Tiagabine
• Voriconazole

Related Chapters

• Rigor mortis