Tehran University of Medical Sciences Archives of Anesthesiology and Critical Care 2423-5849 7 1 2021 02 02 50 52 EN Dheeraj Kapoor Department of Anaesthesia and Intensive Care, Govt. Medical College and Hospital, Chandigarh-160030, India Manju Sharma Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India. Manpreet Singh Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India. Shraddha Sinha Department of Anaesthesia and Intensive Care, Fortis Hospital, Mohali, Punjab, India. Binish Kathuria Department of Anaesthesia, Deep Hospital ,Model Town, Ludhiana, India. 2020 11 16 2020 11 22 Misoprostol is a synthetic prostaglandin E1 analogue and has been reccommended as a safe, effective, easy to administer, cost efficient next in line drug after oxytocin, for the treatment and prevention of postpartum haemorrhage (PPH). Notwithstanding, it causes certain undesirable side effects compared to oxytocin such as nausea, vomiting, shivering, diarrhoea and transient fever. Transient pyrexia is commonly related with misoprostol administration, due to shift of hypothalamic set point. However, hyperpyrexia clubbed with seizures is a rare yet self-limiting side effect and requires prompt management strategies. There have been case reports describing fever following misoprostol administration but only few describing hyperpyrexia and even fewer describing with seizures. We report a case of hyperpyrexia associated with delayed presentation of generalised sezuires after administration of rectal misoprotol and its successful management in critical care settings. https://aacc.tums.ac.ir/index.php/aacc/article/view/317 https://aacc.tums.ac.ir/index.php/aacc/article/download/317/499