Bone marrow fever

Anemia, proteinuria, nausea, vomiting, fever, rash, leukopenia, neutropenia, thrombocytopenia, diarrhea, constipation, alopecia Bone marrow depression, hyperuricemia, hepatotoxicity, skin rash... 

Ulcerative stomatitis, nausea, rash, pruritus, renal failure, bone marrow depression, fatigue, fever, chills... 

Bone marrow depression, anemia, nausea, vomiting, diarrhea, rash, fever... 

Chills, fever, nausea, vomiting, headache, hypotension, hypertension, hypoxia, dyspnea, bone marrow depression Infusion reactions, hypotension, dizziness, anxiety, night sweats, rash, pruritus, nausea, diarrhea, vomiting, bone marrow depression... 

Close monitoring of HCT recipients for infections is necessary because recovery of immune function is slow, sometimes requiring over 2 years, even in the absence of immunosupressants.104 Fevers should be assessed and treated rapidly to minimize the likelihood of a fatal infection. HCT recipients—both autologous and allogeneic—lose protective antibodies to vaccine-preventable diseases the CDC and the European Group for Bone Marrow Transplantation have issued recommendations for reimmunization for HCT recipients.107... 

Cladribine (2-CdA) -purine analogue antimetabolite -bone marrow suppression -fever in 50% (probably due to tumor lysis) -rash in 50% -immunosuppression (with profound T-cell lymphopenia)... 

Dacarbazine (DTIC) -atypical alkylating agent, noncell cycle dependent -bone marrow suppression -nausea and vomiting -vesicant if extravasated -flu-like syndrome -fever... 

Gemcitabine - nucleoside analogue antimetabolite S-phase specific cytotoxicity -bone marrow suppression—most commonly thrombocytopenia -nausea and vomiting -fever during administration -elevated transaminases -rash... 

Interferon -biologic agent -flu-like symptoms-malaise, myalgias, fatigue, fever -nausea and vomiting—mild -anorexia -bone marrow suppression -mucocutaneous effects (stomatitis, mucositis) -cardiovascular effects (arrhythmias, hypotension) -mental status changes (confusion, lethargy, psychosis) -renal impairment (proteinuria) -elevation in transaminase levels... 

Pentostatin -purine analogue antimetabolite inhibits adenosine deaminase -nephrotoxicity (including acute renal failure) -bone marrow suppression -neurotoxicity—lethargy, fatigue, seizures, coma -immunosuppression (lymphopenia) -nausea and vomiting -fever -anorexia -hepatotoxicity... 

Thiotepa -alkylating agent cell cycle independent -bone marrow suppression -nausea and vomiting-uncommon -mucocutaneous effects (mucositis, stomatitis)—uncommon -fever -angioedema -urticaria -secondary leukemia... 

Non-dose-related adverse effects of sulfasalazine include rash, fever, or hepatotoxicity most commonly, as well as relatively uncommon but serious reactions such as bone marrow suppression, thrombocytopenia, pancreatitis, pneumonitis, interstitial nephritis, and hepatitis. 

Bone marrow suppression Allergy, rash, drug fever... 

SYSTEMIC EFFECTS Occurs primarily through inhalation and ingestion. The T vapor or aerosol is less toxic to the skin or eyes than the liquid form. When inhaled, the upper respiratory tract (nose, throat, tracheae) is inflamed after a few hours latency period, accompanied by sneezing, coughing and bronchitis, loss of appetite, diarrhea, fever, and apathy. Exposure to nearly lethal doses of T can produce injury to bone marrow, lymph nodes, and spleen as indicated by a drop in white blood cell (WBC) count and, therefore, results in increased susceptibility to local and systemic infections. Ingestion of T will produce severe stomach pains, vomiting, and bloody stools after a 15-20 minute latency period. 

Mycobacterium is a genus of bacteria that has characteristic cell walls and unusual staining properties. AIDS patients are most commonly infected with an atypical form of tuberculosis bacterium called Mycobacterium avium inter-cellulare. This bacterium does not normally cause disease in healthy people, but in AIDS patients, it may cause tuberculosis-like disease in the lungs. The infection can also involve numerous other tissues, such as the bone marrow, and bacteria may be present in the blood at very high levels. Patients with this opportunistic infection will have fevers and low number of white blood cells. These infections are often resistant to drugs. 

One mechanism by which fever has an antibacterial effect is that it decreases the blood concentration of iron, which is necessary for bacterial proliferation (Chapter 17). However, iron is also necessary for the proliferation of immune cells in the lymph nodes and in the bone marrow (for formation of the iron-containing proteins, haemoglobin and mitochondrial proteins). This leads to competition for iron in the... 

Hematologic/Lymphatic Anemia hemolytic anemia thrombocytopenia thrombocytopenic purpura eosinophilia leukopenia granulocytopenia neutropenia bone marrow depression agranulocytosis reduction of hemoglobin or hematocrit prolongation of bleeding and prothrombin time decrease in WBC and lymphocyte counts increase in lymphocytes, monocytes, basophils, and platelets. Hypersensitivity Adverse reactions (estimated incidence, 1% to 10%) are more likely to occur in individuals with previously demonstrated hypersensitivity. In penicillin-sensitive individuals with a history of allergy, asthma, or hay fever, the reactions may be immediate and severe. 

Harter C, Schulze B, Goldschmidt H, Benner A, Geiss HK, Hoppe-Tichy T et al. Piperachlin/tazobactam vs ceftazidime in the treatment of neutropenic fever in patients with acute leukemia or foUowing autologous peripheral blood stem cell transplantation a prospective randomized trial. Bone Marrow Transplant 2006 37 373-79. 

E. Chloramphenicol is no longer the treatment of choice for any bacterial infection because of the potentially fatal chloramphenicol-induced bone marrow suppression. In the past it has been used against the infections indicated in choices A, B, C, and D. It remains a major treatment for typhoid and paratyphoid fever in some developing countries, since alternative drugs are much more expensive. 

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