II. Types

  1. Hypersensitivity Reaction (associated with Eosinophilia, rash)
  2. Idiosyncratic Reaction
  3. Drug-Induced Hyperthemia Syndromes (Muscle rigidity and fever >40 C)
    1. Malignant Hyperthermia
    2. Neuroleptic Malignant Syndrome
    3. Serotonin Syndrome

III. Signs: Intensive Care Unit Patients

  1. Rigors (53%)
  2. Myalgias (25%)
  3. Leukocytosis (22%)
  4. Eosinophilia (22%)
  5. Rash (18%)
  6. Hypotension (18%)

IV. Causes: Antimicrobial Induced Fever

V. Causes: Cardiovascular Medication Induced Fever

VI. Causes: Anticonvulsant induced fever

VII. Causes: Gastrointestinal Medication induced fever

VIII. Causes: Analgesics

  1. Aspirin
  2. Ibuprofen
  3. Sulindac (Clinoril)
  4. Meperidine (Demerol)

IX. Causes: Miscellaneous Medications Inducing Fever

X. Management

  1. Withdraw suspected medication causes
    1. Expect fever to resolve within 2-3 days (up to 7 days) of medication discontinuation
  2. Exclude other sources of fever
    1. See Acquired Fever in Hospitalized Patients
    2. See Persistent Fever Causes

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