Fever drug-induced

Many drugs have been identified as causes of fever. Drug-induced fever is defined as persistent fever in the absence of infection or other underlying condition. The fever must coincide temporally with the administration of the offending agent and disappear promptly upon its withdrawal, after which the temperature remains normal. 

The side effects of mycophenolate mofetil include diarrhea, abdominal pain, constipation, nausea/vomiting, acne, dyspnea, cough, peripheral edema, increased risk of infections, drug-induced fever, dizziness, headaches, leukopenia and anemia. 

HIV patients These immunocompromised patients with Pneumocystis pneumonia frequently show drug-induced fever, rashes, diarrhea and/or pancytopenia. 

A retrospective analysis of allergic reactions (drug-induced fever and rash) in 90 adults with cystic fibrosis, of whom 26 developed probable allergic reactions to parenteral beta-lactams. There was drug-induced fever in 54 and skin reactions in 28 of 897 treatment courses (6 and 3.1% respectively). There was one case of non-fatal anaphylaxis. The numbers of allergic reactions per number of patients receiving specific antibiotics were carbenicillin 4/56, mezlocillin 7/42, piperacillin 11/31, ticarcUlin 1/20, cefazolin 0/24, ceftazidime 1/35, imipenem + cilastatin 4/16, and nafcillin 3/36 (17). 

Yilmaz HL, Kucukosmanoglu O, Hennes H, Celik T. Salbutamol intoxication is salbutamol a drug-inducing fever A case report and treatment strategy. Eur J Emerg Med 2002 9(2) 179-82. 

Observational studies In a retrospective review of medical charts in a Taiwan hospital, there were 117 patients whose vancomycin treatment had to be stopped because of drug-induced fever n = 24), rash (n — 77), fever and rash (n — 8), or neutropenia (n = 8) [79. After treatment was switched to teicoplanin, only 10% (112 patients) had a recurrence of the drug-induced adverse event four of the eight patients who had had vancomycin-induced neutropenia had neutropenia with teicoplanin. 

A 66-year-old woman was treated with 400 mg intravenous teicoplanin for suspected postoperative endocarditis. Eighteen days into treatment she developed fever and neutropenia. The fevers spiked 40 min following administration of teicoplanin. The neutropenia and fever resolved within a few days following cessation of the treatment [66 ]. This case highlights the potential for drug-induced fever as well as neutropenia and must be considered in patients on long-term antibiotics. 

Suggested Alternatives for Differential Diagnosis Drug induced noncardiac pulmonary edema, acute respiratory distress syndrome, pneumonic plague, tularemia, Q fever, and viral influenza. 

Others Acetazolamide Lithium Thiaazides Phenytoin Rash, fever, autoimmunity Dermatitis autoimmune thyroiditis, vasculitis Hypersensitivity, photosensitivity autoimmunity (diabetes) Rash drug-induced SLE, hepatitis... 

Hepatitis In 1 retrospective study of 7492 patients on rapidly absorbed aminosalicylic acid preparations, drug-induced hepatitis occurred in 38 patients (0.5%) in these 38, the first symptom usually appeared within 3 months of the start of therapy with a rash as the most common event followed by fever and much less freguently by Gl disturbances of anorexia, nausea, or diarrhea. 

Monitor carefully in first 3 mo of therapy for signs of intolerance/drug-induced hepatitis (rash, fever, jaundice, hepatomegaly)... 

Fever and skin rashes are occasionally seen. Drug-induced systemic lupus erythematosus has been reported. 

General Indication Allergic disorders Principal Desired of Glucocorticoids Decreased inflammation Examples of Specific Disorders Anaphylactic reactions, drug-induced allergic reactions, severe hay fever, serum sickness... 

Hypersensitivity syndrome, defined as a drug-induced complex consisting of fever, rash, and internal organ involvement, has been associated with olanzapine (243). 

A 58-year-old man developed stomatitis and widespread edematous erythema with papules and pustules after taking a combination of carbamazepine and paracetamol for 2 days, a most unusual treatment for headache and fever (62). The stomatitis improved but the eruption persisted for 2 months and was diagnosed as eosinophilic pustular folliculitis, a disorder that is rarely drug-induced. Recovery was achieved with glucocorticoid therapy. 

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