drug-induced fever

Etiology: - pharmaceutical agents a) methyldopa b) quinidine c) procainamide d) phenytoin e) carbamazepine f) amphotericin B g) antihistamines h) penicillin i) cephalothin j) tetracycline k) sulfonamide l) nitrofurantoin m) isoniazid n) bleomycin o) aminosalicylate p) allopurinol Clinical manifestations: 1) generally appears several days to 3 weeks after drug has been started, but can begin after several years 2) can arise within hours of a rechallenge 3) rash, urticaria, mucosal ulceration (hypersensitivity) 4) 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

General

adverse drug reaction (ADR) fever

References

Medical Knowledge Self Assessment Program (MKSAP) 14, American College of Physicians, Philadelphia 2006