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[Intermittent fever of unknown origin]
P Osterwalder1, J Koch, B Wüthrich
1Department für Innere Medizin, Universitätsspital Zürich.
Deutsche Medizinische Wochenschrift (1946)
|July 22, 1998
Summary
A patient developed drug fever, a hypersensitivity reaction, due to chlorthalidone, a sulfonamide diuretic. This rare adverse drug reaction resolved after discontinuing the medication.
Area of Science:
- Pharmacology
- Internal Medicine
- Clinical Immunology
Background:
- Drug-induced fever is a significant cause of pyrexia of unknown origin.
- Sulfonamide derivatives are known to cause hypersensitivity reactions, including fever.
Observation:
- A 58-year-old woman presented with a 4-week history of intermittent fever, anemia, and elevated inflammatory markers.
- Initial investigations, including blood cultures and bone marrow biopsy, were unremarkable.
- The patient was on atenolol and recently added chlorthalidone for hypertension.
Findings:
- Fever and inflammatory parameters resolved completely after discontinuing chlorthalidone.
- Lymphocyte transformation tests confirmed hypersensitivity to chlorthalidone.
- This case represents a rare instance of drug fever attributed to chlorthalidone.
Implications:
- Chlorthalidone-induced drug fever should be considered in the differential diagnosis of fever of unknown etiology.
- Clinicians should be vigilant for hypersensitivity reactions to sulfonamide diuretics.
- This case highlights the importance of a thorough medication history and drug withdrawal in diagnosing unexplained fever.