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Suspected Rifampicin-Induced Fever During Periprosthetic Joint Infection Treatment: A Report of 2 Cases

Sophie A Zwarts1, Kyrill Rykov2, Pelle Bos1

  • 1Department of Orthopedic Surgery, Frisius Medical Centre, Leeuwarden, the Netherlands.

JBJS Case Connector
|December 5, 2025
PubMed
Abstract

Insights

Drug-induced fever from rifampicin is rare but possible. Discontinuing the antibiotic rapidly resolved fever in two patients, highlighting the need for careful diagnosis in persistent fever cases.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Rheumatology

Background:

  • Drug-induced fever is an uncommon adverse effect of antibiotics.
  • Rifampicin is a key antibiotic used in treating periprosthetic joint infections.

Purpose of the Study:

  • To report two cases of suspected rifampicin-induced fever.
  • To emphasize the diagnostic considerations for drug-induced fever in patients with periprosthetic joint infections.

Main Methods:

  • Case report methodology.
  • Clinical observation of two patients treated for periprosthetic joint infection with rifampicin.
  • Monitoring of symptoms and response to antibiotic discontinuation.

Main Results:

  • Two patients developed persistent fever despite clinical improvement during rifampicin treatment for periprosthetic joint infection.
  • Absence of typical infectious or inflammatory symptoms was noted.
  • Discontinuation of rifampicin resulted in rapid resolution of fever in both cases.

Conclusions:

  • Drug-induced fever should be suspected in cases of persistent fever without clear infectious signs, especially during antibiotic therapy.
  • Prompt identification and cessation of the offending drug, like rifampicin, can lead to swift recovery.
  • Considering drug-induced fever can prevent unnecessary investigations and interventions.
Keywords:
DAIRPJIS. aureusTHAadultadverse effectsantibiotic treatmentcomplicationelevated CRPfeverinfectionperiprosthetic join infectionrifampicins. epidermidistotal hip arthroplasty

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