Biomedical subjects
Publications and source records attributed to D Mevorach.
A 42 year old woman with Takayasu's arteritis responded to treatment with prednisone (60 mg daily) but developed severe side effects. Cyclophosphamide treatment did not produce a clinical improvement or steroid sparing effect. A treatment trial with a weekly pulse of low dose methotrexate improved her symptoms and the patency of her occluded left subclavian artery.
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Cardiac hypertensive structural changes, catecholamine-related cardiomyopathy, and congestive heart failure (CHF) have been encountered in pheochromocytoma, as a result of prolonged exposure to high concentrations of endogenous catecholamines. A 34-year-old man presented with severe hypertension, cardiomegaly, and CHF, presumably as a result of continuous alpha-adrenergic intoxication with oxymetazoline hydrochloride, phenylephrine hydrochloride, and ephedrine hydrochloride, consumed in massive doses by an overuse of nasal decongestants and cough syrup (daily doses of 20, 100, and 300 mg, respectively). Coadministered chlorpromazine hydrochloride and trimeprazine tartrate may have also contributed to the clinical presentation through their anticholinergic and antihistaminic properties. The possibility of an overuse of these over-the-counter drugs should be considered in the differential diagnosis of hypertensive emergencies, especially with the simultaneous use of anticholinergic and antihistamine medications, beta-blocking agents, or monoamine oxidase inhibitors.
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OBJECTIVE: To report on three patients with cefuroxime-induced fever. CASE SUMMARIES: Recurrence of fever was noted in three patients after five to seven days of cefuroxime sodium therapy for acute exacerbation of chronic obstructive pulmonary disease. No source of infection was found and the fevers resolved within 30 hours of drug discontinuation. One patient was rechallenged; the same pattern of fever resulted. DISCUSSION: Fever secondary to cephalosporin administration is reviewed and the place of cephalosporins in the differential diagnosis of fever is postulated. CONCLUSIONS: Cefuroxime should be added to the list of cephalosporins that induce fever.