Doxycycline-induced drug fever: a case report

Abstract

Drug fever is a febrile reaction induced by a drug without additional clinical symptoms. This adverse reaction is not rare but under diagnosed and under reported. Doxycycline is a tetracycline compound with broad-spectrum antibiotic activity. Drug fever induced by doxycycline is rarely reported. In this study, we describe a patient in whom doxycycline induced drug fever after 17 days of therapy for brucellosis.

Drug fever induced by antibiotics of β-lactams in a patient after posterior cervical spine surgery—A case report and literature review

“…The onset timing and pattern of the fever are mostly not useful in making an accurate diagnosis, but they really play an important auxiliary role in making a differentiating diagnosis. Accordingly, the average time it takes to onset is generally 7–10 days ( 10 – 12 ) but can also vary from hours to even several months ( 13 ), which is mostly consistent with our reviewed literature, ranging from 4 h ( 14 ) to 17 days ( 2 , 15 ) ( Table 1 ). After discontinuation of the offending drugs, the full resolution of fever generally takes 2–3 days, although it may still persist for days or even weeks if other manifestations of hypersensitivity come along with the fever, such as a widespread rash, or if the elimination rate of a certain agent remains low ( 16 ).…”

Unusual Drug Fever Caused by Imipenem/Cilastatin and a Review of Literature

“…In spite of that, especially because of DF overlapping with the duration of anti-infection therapy, DF should not be ignored by clinicians. Monitoring these inflammatory markers can help clinicians to confirm DF [Patel 2010;Yuan 2016]. When DF is suspected by clinicians, the drug should be discontinued.…”

“…Our patient developed DF caused by imipenem/cilastatin. Although DF is not a serious complication, it may lead to unnecessary costs, prolonged hospitalization, and overuse of antibiotics, which results in the generation of drug-resistant bacteria [Vodovar 2012;Yuan 2016]. Though the diagnosis of DF is challenging, in cases of unexplained fever, especially in the absence of apparent infection, the diagnosis of DF should be considered.…”

Recurrent severe neutropenia following doxycycline use in a young healthy woman

“…The commonly encountered adverse effects of doxycycline include photosensitivity, esophageal erosion, and other gastrointestinal symptoms 3,5,6 . Rarely reported side effects include Stevens–Johnson Syndrome, hypoglycemia, drug‐induced fever, and amnesia 7–10 . A diagnosis of doxycycline‐induced neutropenia in our case is favored by the recurrence of neutropenia with repeat doxycycline exposure and remission with cessation, bolstered by granulocyte colony‐stimulating factor administration.…”

“…3,5,6 Rarely reported side effects include Stevens-Johnson Syndrome, hypoglycemia, drug-induced fever, and amnesia. [7][8][9][10] A diagnosis of doxycycline-induced neutropenia in our case is favored by the recurrence of neutropenia with repeat doxycycline exposure and remission with cessation, bolstered by granulocyte colony-stimulating factor administration. This is further supported by the extensive and conclusively negative diagnostic workup (summarized in Table 1).…”