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Drug-Induced Fever

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Drug-Induced Fever, Drug Induced Fever, Fever Due to Medications, Drug Fever, Drug-Induced Hyperpyrexia

  • See Also
  1. Fever
  2. Fever of Unknown Origin
  3. Fever of Unknown Origin History
  4. Drug-Induced Fever
  5. Fever of Unknown Origin Causes
  6. Fever of Unknown Origin Causes by Age
  7. Fever in the Returning Traveler
  8. Fever of Unknown Origin Causes in Comorbid Conditions
  9. Fever of Unknown Origin History
  • Types
  1. Hypersensitivity Reaction (associated with Eosinophilia, rash)
  2. Idiosyncratic Reaction
  3. Drug-Induced Hyperthemia Syndromes (Muscle rigidity and fever >40 C)
    1. Malignant Hyperthermia
    2. Neuroleptic Malignant Syndrome
    3. Serotonin Syndrome
  1. Rigors (53%)
  2. Myalgias (25%)
  3. Leukocytosis (22%)
  4. Eosinophilia (22%)
  5. Rash (18%)
  6. Hypotension (18%)
  • Causes
  • Antimicrobial Induced Fever
  1. Amphotericin
  2. Carbapenems
  3. Cephalosporins (common)
  4. Erythromycin
  5. Isoniazid
  6. Minocycline
  7. Penicillins (common)
  8. Nitrofurantoin
  9. Rifampin
  10. Sulfonamides
  11. Vancomycin
  • Causes
  • Cardiovascular Medication Induced Fever
  1. Atropine
  2. Captopril
  3. Clofibrate
  4. Hydralazine
  5. Hydrochlorothiazide
  6. Methyldopa
  7. Nifedipine
  8. Procainamide (common)
  9. Quinidine (common)
  10. Streptokinase
  • Causes
  • Anticonvulsant induced fever
  1. Barbiturates
  2. Carbamazepine (Tegretol)
  3. Phenytoin or Dilantin (common)
  • Causes
  • Gastrointestinal Medication induced fever
  1. Cimetidine (Tagemet)
  2. Ranitidine (Zantac)
  3. Phenothiazines
  1. Aspirin
  2. Ibuprofen
  3. Sulindac (Clinoril)
  4. Meperidine (Demerol)
  • Causes
  • Miscellaneous Medications Inducing Fever
  1. Allopurinol
  2. Heparin
  • Management
  1. Withdraw suspected medication causes
    1. Expect fever to resolve within 2-3 days (up to 7 days) of medication discontinuation
  2. Exclude other sources of fever
    1. See Acquired Fever in Hospitalized Patients
    2. See Persistent Fever Causes
  • References
  1. Marino (2014) The ICU Book, p. 777-95
  2. Hersch (2014) Am Fam Physician 90(2): 91-6 [PubMed]
  3. Johnson (1996) Infect Dis Clin North Am 10(1): 85-91 [PubMed]