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. [1]

  • Most common classes associated with drug fever are antimicrobials, anticonvulsants, antidysrhythmics, and other cardiac agents[2]

Clinical Features
  • Can occur at any point during therapy but most often occurs 7-10 days after initiation of drug[3]
  • May appear "inappropriately well" for the degree of fever

Differential Diagnosis

Infectious

Non-infectious

Evaluation
  • Thorough history and physical exam including review of medications

Diagnosis
  • Diagnosis of exclusion

Management
  • Withdrawal of offending agent

Disposition


See Also



References
  1. Wikipedia, the Free Encyclopedia, "Drug-Induced hyperthermia" <https://en.wikipedia.org/wiki/Drug-induced_hyperthermia>, accessed 13 Jan 2021
  2. Patel, R. A., & Gallagher, J. C. (2010). Drug Fever. Pharmacotherapy, 30(1), 57–69. doi:10.1592/phco.30.1.57
  3. Patel, R. A., & Gallagher, J. C. (2010). Drug Fever. Pharmacotherapy, 30(1), 57–69. doi:10.1592/phco.30.1.57
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