drug-induced fever

Etiology

• pharmaceutical agents
  • methyldopa
  • quinidine
  • procainamide
  • phenytoin
  • carbamazepine
  • amphotericin B
  • antihistamines
  • penicillin
  • cephalothin
  • tetracycline
  • sulfonamide
  • nitrofurantoin
  • isoniazid
  • bleomycin
  • aminosalicylate
  • allopurinol

Clinical manifestations

• generally appears several days to 3 weeks after drug has been started, but can begin after several years
• can arise within hours of a rechallenge
• rash, urticaria, mucosal ulceration (hypersensitivity)
• hepatic dysfunction, renal dysfunction

Laboratory

• complete blood count (CBC)
  • may be leukocytosis or leukopenia
• abnormal liver function tests (90%)
  • serum aminotransferases (serum ALT, serum AST) elevated

Management

• defervescence 1-3 days after discontinuation of the drug

More general terms

• adverse drug reaction (ADR)
• fever