Drug fever

Background

Drug fever, or Drug-induced hyperthermia, is an adverse reaction to a drug in which the recipient of the drug develops a fever in direct response to receiving a specific drug. There are multiple mechanisms by which a drug can directly cause a fever response. These mechanisms include inducing a hyper-metabolic state, direct tissue damage and tissue necrosis, interference with peripheral vasodilation, activation of the cellular or humoral immune responses, or by acting as an endogenous pyrogen.

Differential Diagnosis

Fever

Infectious

• Critical
  • Sepsis
  • PNA with respiratory failure
  • Peritonitis
  • Meningitis
  • Cavernous Sinus Thrombosis
  • Necrotizing Fasciitis
• Emergent
  • PNA
  • Peritonsillar Abscess
  • Retropharyngeal Abscess
  • Epiglottitis
  • Endocarditis
  • Pericarditis
  • Appendicitis
  • Cholecystitis
  • Diverticulitis
  • Intra-abdominal abscess
  • Pyelonephritis
  • Tubo-ovarian abscess
  • Encephalitis
  • Brain abscess
  • Cellulitis
  • Abscess
  • Malaria
• Non-emergent
  • Viral syndrome
  • Otitis Media
  • Sinusitis
  • Pharyngitis
  • Influenza
  • TB
  • UTI
  • Epididymitis
  • Prostatitis

Non-infectious

• Critical
  • AMI
  • PE
  • Intracranial Hemorrhage
  • CVA
  • NMS
  • Thyroid Storm
  • Acute Adrenal Insufficiency
  • Transfusion Rx
  • Pulmonary Edema
  • Heat Stroke
  • Malignant hyperthermia
• Emergent
  • CHF
  • Dehydration
  • Recent Seizure
  • Sickle Cell Dz
  • Transplant rejection
  • Pancreatitis
  • DVT
  • Serotonin Syndrome
• Non-emergent
  • Drug fever (except as in NMS and Serotonin Syndrome)
  • Malignancy
  • Gout
  • Sarcoidosis
  • Crohn's Disease
  • Postmyocardiotomy sy

Evaluation

Diagnosis

• Diagnosis of exclusion

Management

• Withdrawal of offending agent