Drug fever

Background

  • Also known as drug-induced hyperthermia
  • An adverse reaction to a drug in which the recipient of the drug develops a fever
    • Most common drug classes are antimicrobials, anticonvulsants, antidysrhythmics, and other cardiac agents[1]

Pathophysiology

Possible mechanisms:

  • Hyper-metabolic state
  • Direct tissue damage and tissue necrosis
  • Interference with peripheral vasodilation
  • Activation of the cellular or humoral immune responses
  • Acting as an endogenous pyrogen.

Clinical Features

  • Can occur at any point during therapy but most often occurs 7-10 days after initiation of drug[2]
  • May appear "inappropriately well" for the degree of fever

Differential Diagnosis

Fever

Infectious

Non-infectious

Evaluation

Workup

  • Thorough history and physical exam including review of medications

Diagnosis

  • Diagnosis of exclusion

Management

  • Withdrawal of offending agent

Disposition

See Also

External Links

References

  1. Patel, R. A., & Gallagher, J. C. (2010). Drug Fever. Pharmacotherapy, 30(1), 57–69. doi:10.1592/phco.30.1.57
  2. Patel, R. A., & Gallagher, J. C. (2010). Drug Fever. Pharmacotherapy, 30(1), 57–69. doi:10.1592/phco.30.1.57