Drug fever

Drug fever is a febrile response that occurs in reaction to the administration of a drug. It is a type of adverse drug reaction or drug hypersensitivity reaction that can be caused by a wide range of medications, including antibiotics, anticonvulsants, and anti-inflammatory drugs. The mechanism behind drug fever is not fully understood, but it is thought to involve the drug acting as a hapten, leading to an immune response that results in fever.

Causes

Drug fever can be caused by various mechanisms, including:

• Hypersensitivity reactions
• Direct stimulation of the hypothalamus
• Pyrogen release
• Altered thermoregulation

Common drugs that have been associated with drug fever include:

• Beta-lactam antibiotics
• Sulfonamides
• Phenytoin
• Barbiturates
• Isoniazid

Symptoms

The primary symptom of drug fever is an elevated body temperature, typically above 38°C (100.4°F). Other symptoms may include chills, rash, and lymphadenopathy. The onset of symptoms can vary, occurring within hours to weeks after starting the offending medication.

Diagnosis

Diagnosis of drug fever involves a process of elimination. It is important to rule out other causes of fever, such as infection or malignancy, before attributing the fever to a drug. A detailed medical history and review of medications are crucial. Discontinuation of the suspected drug often leads to resolution of the fever, which can help confirm the diagnosis.

Treatment

The primary treatment for drug fever is discontinuation of the offending drug. Antipyretics may be used to manage fever, but the mainstay of treatment is identifying and stopping the causative medication. In cases where the drug cannot be discontinued, management of symptoms and close monitoring may be required.

Prevention

Prevention of drug fever involves careful selection of medications, with consideration of potential adverse reactions. Healthcare providers should be vigilant for signs of drug fever, especially in patients starting new medications.