Drug fever - Revision history

Aidan: /* Etiology */

2026-01-06T18:40:12Z

Etiology

← Older revision		Revision as of 18:40, 6 January 2026
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	*Long list of offending medication, mostly based on collections of case reports[[CiteRef::mackowiak1987dr]][[CiteRef::patel2010dr]]		*Long list of offending medication, mostly based on collections of case reports[[CiteRef::mackowiak1987dr]][[CiteRef::patel2010dr]]
	*Antimicrobials are the most common overall class		*'''Antimicrobials are the most common overall class'''
	**Penicillins are most common, including [[penicillin]], [[piperacillin]], [[ticarcillin]] [[ampicillin]], [[methicillin]], [[carbenicillin]], [[mezlocillin]], [[staphcillin]], [[nafcillin]], [[oxacillin]], and [[cloxacillin]]		**'''Penicillins''' are most common, including [[penicillin]], [[piperacillin]], [[ticarcillin]] [[ampicillin]], [[methicillin]], [[carbenicillin]], [[mezlocillin]], [[staphcillin]], [[nafcillin]], [[oxacillin]], and [[cloxacillin]]
	**Cephalosporins, including [[cefazolin]], [[cefotaxime]], [[ceftazidime]], [[cephalexin]], and [[cephalothin]]		**Cephalosporins, including [[cefazolin]], [[cefotaxime]], [[ceftazidime]], [[cephalexin]], and [[cephalothin]]
	**[[Tetracycline]] and [[minocyline]]		**[[Tetracycline]] and [[minocyline]]
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	**Case reports with [[clofibrate]], [[diltiazem]], [[furosemide]], [[heparin]], [[hydralazine]], [[hydrochlorothiazide]], [[nifedipine]], [[oxprenelol]], and [[triameterene]]		**Case reports with [[clofibrate]], [[diltiazem]], [[furosemide]], [[heparin]], [[hydralazine]], [[hydrochlorothiazide]], [[nifedipine]], [[oxprenelol]], and [[triameterene]]
	*Neurologic medications		*Neurologic medications
	**[[Phenytoin]] is the most common within this class		**'''[[Phenytoin]]''' is the most common within this class
	**[[Dexmedetomidine]]		**[[Dexmedetomidine]]
	**[[Lysergic acid]]		**[[Lysergic acid]]

Aidan: links

2022-12-14T19:48:20Z

links

← Older revision		Revision as of 19:48, 14 December 2022
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	**[[NSAIDs]], including [[ibuprofen]], [[tolmetin]], and [[aspirin]]		**[[NSAIDs]], including [[ibuprofen]], [[tolmetin]], and [[aspirin]]
	**Case reports of [[everolimus]], [[mycophenolate mofetil]], and [[sirolimus]]		**Case reports of [[everolimus]], [[mycophenolate mofetil]], and [[sirolimus]]
	*Other medications, including allopurinol, cimetidine, clofibrate, folate, interferon, iodide, levamisole, metoclopramide, piperazine, propylthiouracil, prostaglandin E2, ritodrine, ~~theeophylline~~, and thyroxine		*Other medications, including [[allopurinol]], [[cimetidine]], [[clofibrate]], [[folate]], [[interferon]], [[iodide]], [[levamisole]], [[metoclopramide]], [[piperazine]], [[propylthiouracil]], [[prostaglandin E2]], [[ritodrine]], [[theophylline]], and [[thyroxine]]

	==Clinical Manifestations==		==Clinical Manifestations==

Aidan at 10:27, 21 November 2022

2022-11-21T10:27:00Z

← Older revision		Revision as of 10:27, 21 November 2022
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	*Neurologic medications		*Neurologic medications
	**[[Phenytoin]] is the most common within this class		**[[Phenytoin]] is the most common within this class
			**[[Dexmedetomidine]]
	**[[Lysergic acid]]		**[[Lysergic acid]]
	**[[Carbamazepine]]		**[[Carbamazepine]]

Aidan at 17:30, 1 September 2020

2020-09-01T17:30:41Z

← Older revision		Revision as of 17:30, 1 September 2020
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	== ~~Backgroun~~ ==		==Background==

	*A drug reaction of unclear mechanism that causes isolated fever		*A drug reaction of unclear mechanism that causes isolated fever
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	*Occasional leukocytosis or eosinophilia		*Occasional leukocytosis or eosinophilia

	== Management ==		==Management==

	* Stop offending medication		*Stop offending medication

	==Further Reading==		==Further Reading==

Aidan at 12:38, 1 September 2020

2020-09-01T12:38:54Z

← Older revision		Revision as of 12:38, 1 September 2020
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			== Backgroun ==
	* A drug reaction of unclear mechanism that causes isolated fever

			*A drug reaction of unclear mechanism that causes isolated fever
	== Pathophysiology ==
	* Stipulated to involve any of five mechanisms:
	** Altered thermoregulation, including anticholinergics
	** Drug administration-related fever, including [[amphotericin B]], cephalosporins, and [[vancomycin]]
	** Expected drug effect, including chemotherapy (tumour lysis) and penicillins ([[Jarisch-Herxheimer reaction]])
	** Idiosyncratic reactions, including [[primaquine]], [[quinidine]], [[quinine]], and sulfonamides
	** Hypersensitivity reaction, including allopurinol, [[quinidine]], [[quinine]], and sulfonamides

			===Pathophysiology===
	== Etiology ==
	* Long list of offending medication, mostly based on collections of case reports[[CiteRef::mackowiak1987dr]][[CiteRef::patel2010dr]]
	* Antimicrobials are the most common overall class
	** Penicillins are most common, including [[penicillin]], [[piperacillin]], [[ticarcillin]] [[ampicillin]], [[methicillin]], [[carbenicillin]], [[mezlocillin]], [[staphcillin]], [[nafcillin]], [[oxacillin]], and [[cloxacillin]]
	** Cephalosporins, including [[cefazolin]], [[cefotaxime]], [[ceftazidime]], [[cephalexin]], and [[cephalothin]]
	** [[Tetracycline]] and [[minocyline]]
	** [[Trimethoprim-sulfamethoxazole]]
	** [[Isoniazid]]
	** [[Nitrofurantoin]]
	** Case reports of [[acyclovir]], [[amphotericin B]], [[aureomycin]], [[colistin]], [[declomycin]], [[erythromycin]], [[furadantin]], [[mebendazole]], [[novobiocin]], [[para-aminosalicylic acid]], [[rifampin]], [[streptomycin]], [[terramycin]], and [[vancomycin]]
	* Cardiovascular
	** Methyldopa
	** Quinidine and quinine
	** Procainamide
	** Dobutamine
	** Case reports with clofibrate, diltiazem, furosemide, heparin, hydralazine, hydrochlorothiazide, nifedipine, oxprenelol, and triameterene
	* Neurologic medications
	** Phenytoin is the most common within this class
	** Lysergic acid
	** Carbamazepine
	** Nomifensine
	** Thioradazine
	** Case reports of amphetamine, doxepin, haloperidol, nomifensine, sulfasalazine, triamterene, benztropine, and trifluoperazine
	* Chemotherapy and immunomodulators
	** Bleomycin
	** Streptomycin
	** Case reports of 6-mercaptopurine, chlorambucil, cisplatin, cytarabine, cytosine arabinoside, daunorubicin, hydroxyurea, L-asparaginase, procarbazine, streptozocin, and vincristine
	* Antiinflammatory or immunomodulatory medications
	** Azathioprine
	** NSAIDs, including ibuprofen, tolmetin, and aspirin
	** Case reports of everolimus, mycophenolate mofetil, and sirolimus
	* Other medications, including allopurinol, cimetidine, clofibrate, folate, interferon, iodide, levamisole, metoclopramide, piperazine, propylthiouracil, prostaglandin E2, ritodrine, theeophylline, and thyroxine

			*Stipulated to involve any of five mechanisms:
	== Clinical Manifestations ==
			**Altered thermoregulation, including anticholinergics
	* Fever without focus and no other likely causes
			**Drug administration-related fever, including [[amphotericin B]], cephalosporins, and [[vancomycin]]
	* Can occur at any point in administration of the medication, but most often 7 to 10 days after starting
			**Expected drug effect, including chemotherapy (tumour lysis) and penicillins ([[Jarisch-Herxheimer reaction]])
	* Fever pattern was mostly unpredictable, but could be intermittent or remittent (high but fluctuating); rarely continuous
			**Idiosyncratic reactions, including [[primaquine]], [[quinidine]], [[quinine]], and sulfonamides
	* Fever most commonly high, but could be low-grade
			**Hypersensitivity reaction, including allopurinol, [[quinidine]], [[quinine]], and sulfonamides
	* Usually appear well, even when febrile, including a relative bradycardia
	* Many have rigors, and may occasionally have other systemic signs or symptoms
	* Occasional leukocytosis or eosinophilia

			===Etiology===
	== Further Reading ==

	* Drug fever. ''Pharmacotherapy''. 2010;30(1):57-69. doi: [https://doi.org/10.1592/phco.30.1.57 10.1592/phco.30.1.57]
			*Long list of offending medication, mostly based on collections of case reports[[CiteRef::mackowiak1987dr]][[CiteRef::patel2010dr]]
			*Antimicrobials are the most common overall class
			**Penicillins are most common, including [[penicillin]], [[piperacillin]], [[ticarcillin]] [[ampicillin]], [[methicillin]], [[carbenicillin]], [[mezlocillin]], [[staphcillin]], [[nafcillin]], [[oxacillin]], and [[cloxacillin]]
			**Cephalosporins, including [[cefazolin]], [[cefotaxime]], [[ceftazidime]], [[cephalexin]], and [[cephalothin]]
			**[[Tetracycline]] and [[minocyline]]
			**[[Trimethoprim-sulfamethoxazole]]
			**[[Isoniazid]]
			**[[Nitrofurantoin]]
			**Case reports of [[acyclovir]], [[amphotericin B]], [[aureomycin]], [[colistin]], [[declomycin]], [[erythromycin]], [[furadantin]], [[mebendazole]], [[novobiocin]], [[para-aminosalicylic acid]], [[rifampin]], [[streptomycin]], [[terramycin]], and [[vancomycin]]
			*Cardiovascular
			**[[Methyldopa]]
			**[[Quinidine]] and [[quinine]]
			**[[Procainamide]]
			**[[Dobutamine]]
			**Case reports with [[clofibrate]], [[diltiazem]], [[furosemide]], [[heparin]], [[hydralazine]], [[hydrochlorothiazide]], [[nifedipine]], [[oxprenelol]], and [[triameterene]]
			*Neurologic medications
			**[[Phenytoin]] is the most common within this class
			**[[Lysergic acid]]
			**[[Carbamazepine]]
			**[[Nomifensine]]
			**[[Thioradazine]]
			**Case reports of [[amphetamine]], [[doxepin]], [[haloperidol]], [[nomifensine]], [[sulfasalazine]], [[triamterene]], [[benztropine]], and [[trifluoperazine]]
			*Chemotherapy and immunomodulators
			**[[Bleomycin]]
			**[[Streptomycin]]
			**Case reports of [[6-mercaptopurine]], [[chlorambucil]], [[cisplatin]], [[cytarabine]], [[cytosine arabinoside]], [[daunorubicin]], [[hydroxyurea]], [[L-asparaginase]], [[procarbazine]], [[streptozocin]], and [[vincristine]]
			*Antiinflammatory or immunomodulatory medications
			**[[Azathioprine]]
			**[[NSAIDs]], including [[ibuprofen]], [[tolmetin]], and [[aspirin]]
			**Case reports of [[everolimus]], [[mycophenolate mofetil]], and [[sirolimus]]
			*Other medications, including allopurinol, cimetidine, clofibrate, folate, interferon, iodide, levamisole, metoclopramide, piperazine, propylthiouracil, prostaglandin E2, ritodrine, theeophylline, and thyroxine

			==Clinical Manifestations==

			*Fever without focus and no other likely causes
			*Can occur at any point in administration of the medication, but most often 7 to 10 days after starting
			*Fever pattern was mostly unpredictable, but could be intermittent or remittent (high but fluctuating); rarely continuous
			*Fever most commonly high, but could be low-grade
			*Usually appear well, even when febrile, including a relative bradycardia
			*Many have rigors, and may occasionally have other systemic signs or symptoms
			*Occasional leukocytosis or eosinophilia

			== Management ==

			* Stop offending medication

			==Further Reading==

			*Drug fever. ''Pharmacotherapy''. 2010;30(1):57-69. doi: [https://doi.org/10.1592/phco.30.1.57 10.1592/phco.30.1.57]

	[[Category:Fever syndromes]]		[[Category:Fever syndromes]]

Aidan: Text replacement - "Clinical Presentation" to "Clinical Manifestations"

2020-07-14T23:15:41Z

Text replacement - "Clinical Presentation" to "Clinical Manifestations"

← Older revision		Revision as of 23:15, 14 July 2020
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	* Other medications, including allopurinol, cimetidine, clofibrate, folate, interferon, iodide, levamisole, metoclopramide, piperazine, propylthiouracil, prostaglandin E2, ritodrine, theeophylline, and thyroxine		* Other medications, including allopurinol, cimetidine, clofibrate, folate, interferon, iodide, levamisole, metoclopramide, piperazine, propylthiouracil, prostaglandin E2, ritodrine, theeophylline, and thyroxine

	== Clinical ~~Presentation~~ ==		== Clinical Manifestations ==
	* Fever without focus and no other likely causes		* Fever without focus and no other likely causes
	* Can occur at any point in administration of the medication, but most often 7 to 10 days after starting		* Can occur at any point in administration of the medication, but most often 7 to 10 days after starting

Aidan: /* Etiology */

2020-06-28T01:32:52Z

Etiology

← Older revision		Revision as of 01:32, 28 June 2020
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	* Long list of offending medication, mostly based on collections of case reports[[CiteRef::mackowiak1987dr]][[CiteRef::patel2010dr]]		* Long list of offending medication, mostly based on collections of case reports[[CiteRef::mackowiak1987dr]][[CiteRef::patel2010dr]]
	* Antimicrobials are the most common overall class		* Antimicrobials are the most common overall class
	** Penicillins are most common, including [[penicillin]], [[piperacillin]], [[ticarcillin]] [[ampicillin]], [[methicillin]], [[carbenicillin]], [[mezlocillin]], [[staphcillin]], [[nafcillin], [[oxacillin]], and [[cloxacillin]]		** Penicillins are most common, including [[penicillin]], [[piperacillin]], [[ticarcillin]] [[ampicillin]], [[methicillin]], [[carbenicillin]], [[mezlocillin]], [[staphcillin]], [[nafcillin]], [[oxacillin]], and [[cloxacillin]]
	** Cephalosporins, including [[cefazolin]], [[cefotaxime]], [[ceftazidime]], [[cephalexin]], and [[cephalothin]]		** Cephalosporins, including [[cefazolin]], [[cefotaxime]], [[ceftazidime]], [[cephalexin]], and [[cephalothin]]
	** [[Tetracycline]] and [[minocyline]]		** [[Tetracycline]] and [[minocyline]]

Aidan: /* Etiology */

2019-11-16T02:05:44Z

Etiology

← Older revision		Revision as of 02:05, 16 November 2019
Line 10:		Line 10:

	== Etiology ==		== Etiology ==
	* ~~Antimicrobials~~ ~~are~~ ~~the~~ ~~most~~ ~~common~~ ~~overall~~ ~~class~~[[CiteRef::mackowiak1987dr]][[CiteRef::patel2010dr]]		* Long list of offending medication, mostly based on collections of case reports[[CiteRef::mackowiak1987dr]][[CiteRef::patel2010dr]]
			* Antimicrobials are the most common overall class
	** Penicillins are most common, including [[penicillin]], [[piperacillin]], [[ticarcillin]] [[ampicillin]], [[methicillin]], [[carbenicillin]], [[mezlocillin]], [[staphcillin]], [[nafcillin], [[oxacillin]], and [[cloxacillin]]		** Penicillins are most common, including [[penicillin]], [[piperacillin]], [[ticarcillin]] [[ampicillin]], [[methicillin]], [[carbenicillin]], [[mezlocillin]], [[staphcillin]], [[nafcillin], [[oxacillin]], and [[cloxacillin]]
	** Cephalosporins, including [[cefazolin]], [[cefotaxime]], [[ceftazidime]], [[cephalexin]], and [[cephalothin]]		** Cephalosporins, including [[cefazolin]], [[cefotaxime]], [[ceftazidime]], [[cephalexin]], and [[cephalothin]]

Aidan: /* Etiology */ fixed citation

2019-11-16T02:05:13Z

Etiology: fixed citation

← Older revision		Revision as of 02:05, 16 November 2019
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	== Etiology ==		== Etiology ==
	* Antimicrobials are the most common overall class[[CiteRef::mackowiak1987dr]][[patel2010dr]]		* Antimicrobials are the most common overall class[[CiteRef::mackowiak1987dr]][[CiteRef::patel2010dr]]
	** Penicillins are most common, including [[penicillin]], [[piperacillin]], [[ticarcillin]] [[ampicillin]], [[methicillin]], [[carbenicillin]], [[mezlocillin]], [[staphcillin]], [[nafcillin], [[oxacillin]], and [[cloxacillin]]		** Penicillins are most common, including [[penicillin]], [[piperacillin]], [[ticarcillin]] [[ampicillin]], [[methicillin]], [[carbenicillin]], [[mezlocillin]], [[staphcillin]], [[nafcillin], [[oxacillin]], and [[cloxacillin]]
	** Cephalosporins, including [[cefazolin]], [[cefotaxime]], [[ceftazidime]], [[cephalexin]], and [[cephalothin]]		** Cephalosporins, including [[cefazolin]], [[cefotaxime]], [[ceftazidime]], [[cephalexin]], and [[cephalothin]]

Aidan: Initial page creation

2019-11-16T02:03:29Z

Initial page creation

New page

* A drug reaction of unclear mechanism that causes isolated fever

== Pathophysiology ==
* Stipulated to involve any of five mechanisms:
** Altered thermoregulation, including anticholinergics
** Drug administration-related fever, including [[amphotericin B]], cephalosporins, and [[vancomycin]]
** Expected drug effect, including chemotherapy (tumour lysis) and penicillins ([[Jarisch-Herxheimer reaction]])
** Idiosyncratic reactions, including [[primaquine]], [[quinidine]], [[quinine]], and sulfonamides
** Hypersensitivity reaction, including allopurinol, [[quinidine]], [[quinine]], and sulfonamides

== Etiology ==
* Antimicrobials are the most common overall class[[CiteRef::mackowiak1987dr]][[patel2010dr]]
** Penicillins are most common, including [[penicillin]], [[piperacillin]], [[ticarcillin]] [[ampicillin]], [[methicillin]], [[carbenicillin]], [[mezlocillin]], [[staphcillin]], [[nafcillin], [[oxacillin]], and [[cloxacillin]]
** Cephalosporins, including [[cefazolin]], [[cefotaxime]], [[ceftazidime]], [[cephalexin]], and [[cephalothin]]
** [[Tetracycline]] and [[minocyline]]
** [[Trimethoprim-sulfamethoxazole]]
** [[Isoniazid]]
** [[Nitrofurantoin]]
** Case reports of [[acyclovir]], [[amphotericin B]], [[aureomycin]], [[colistin]], [[declomycin]], [[erythromycin]], [[furadantin]], [[mebendazole]], [[novobiocin]], [[para-aminosalicylic acid]], [[rifampin]], [[streptomycin]], [[terramycin]], and [[vancomycin]]
* Cardiovascular
** Methyldopa
** Quinidine and quinine
** Procainamide
** Dobutamine
** Case reports with clofibrate, diltiazem, furosemide, heparin, hydralazine, hydrochlorothiazide, nifedipine, oxprenelol, and triameterene
* Neurologic medications
** Phenytoin is the most common within this class
** Lysergic acid
** Carbamazepine
** Nomifensine
** Thioradazine
** Case reports of amphetamine, doxepin, haloperidol, nomifensine, sulfasalazine, triamterene, benztropine, and trifluoperazine
* Chemotherapy and immunomodulators
** Bleomycin
** Streptomycin
** Case reports of 6-mercaptopurine, chlorambucil, cisplatin, cytarabine, cytosine arabinoside, daunorubicin, hydroxyurea, L-asparaginase, procarbazine, streptozocin, and vincristine
* Antiinflammatory or immunomodulatory medications
** Azathioprine
** NSAIDs, including ibuprofen, tolmetin, and aspirin
** Case reports of everolimus, mycophenolate mofetil, and sirolimus
* Other medications, including allopurinol, cimetidine, clofibrate, folate, interferon, iodide, levamisole, metoclopramide, piperazine, propylthiouracil, prostaglandin E2, ritodrine, theeophylline, and thyroxine

== Clinical Presentation ==
* Fever without focus and no other likely causes
* Can occur at any point in administration of the medication, but most often 7 to 10 days after starting
* Fever pattern was mostly unpredictable, but could be intermittent or remittent (high but fluctuating); rarely continuous
* Fever most commonly high, but could be low-grade
* Usually appear well, even when febrile, including a relative bradycardia
* Many have rigors, and may occasionally have other systemic signs or symptoms
* Occasional leukocytosis or eosinophilia

== Further Reading ==
* Drug fever. ''Pharmacotherapy''. 2010;30(1):57-69. doi: [https://doi.org/10.1592/phco.30.1.57 10.1592/phco.30.1.57]

[[Category:Fever syndromes]]