minocycline and Fever

Topics: Arthralgia; Erythema; Female; Fever; Humans; Lower Extremity; Middle Aged; Minocycline; Polyarteritis Nodosa

Because minocycline can cause serious adverse events including hypersensitivity syndrome reaction (HSR), serum sicknesslike reaction (SSLR), and drug-induced lupus, a follow-up study based on a retrospective review of our Drug Safety Clinic and the Health Protection Branch databases and a literature review was conducted to determine if similar rare events are associated with tetracycline and doxycycline. Cases of isolated single organ dysfunction (SOD) attributable to the use of these antibiotics also were identified.. Nineteen cases of HSR due to minocycline, 2 due to tetracycline, and 1 due to doxycycline were identified. Eleven cases of SSLR due to minocycline, 3 due to tetracycline, and 2 due to doxycycline were identified. All 33 cases of drug-induced lupus were attributable to minocycline. Forty cases of SOD from minocycline, 37 cases from tetracycline, and 6 from doxycycline were detected. Hypersensitivity syndrome reaction, SSLR, and SOD occur on average within 4 weeks of therapy, whereas minocycline-induced lupus occurs on average 2 years after the initiation of therapy.. Early serious events occurring during the course of tetracycline antibiotic treatment include HSR, SSLR, and SOD. Drug-induced lupus, which occurs late in the course of therapy, is reported only with minocycline. We theorize that minocycline metabolism may account for the increased frequency of serious adverse events with this drug.

Topics: Adolescent; Adult; Adverse Drug Reaction Reporting Systems; Anti-Bacterial Agents; Arthralgia; Canada; Databases as Topic; Doxycycline; Drug Eruptions; Drug Hypersensitivity; Drug Prescriptions; Female; Fever; Follow-Up Studies; Humans; Liver; Lupus Erythematosus, Systemic; Male; Middle Aged; Minocycline; Retrospective Studies; Safety; Serum Sickness; Syndrome; Tetracycline; Time Factors

Topics: Amplified Fragment Length Polymorphism Analysis; Anti-Bacterial Agents; Antibodies, Bacterial; Ehrlichia chaffeensis; Ehrlichiosis; Female; Fever; Headache; Humans; Middle Aged; Minocycline; Serologic Tests; Taiwan; Treatment Outcome

Hyperthermia is most dangerous clinical symptom of acute MDMA administration, and a key factor related to potentially life-threatening MDMA-induced complications. MDMA induces a consistently faster onset of brain hyperthermia when compared to a delayed and moderate hyperthermia in the body, and the most harmful effects of MDMA are related to its modulation of neural functions. The primary focus of this study was to investigate the effects of minocycline, a centrally acting tetracycline derivative on MDMA-induced brain hyperthermia at high ambient temperature. However, we also simultaneously recorded body temperature, heart rate, and locomotor activity changes, allowing us to gain a better understanding of the mechanisms underlying the MDMA-induced hyperthermic response. We also investigated the effects of MDMA at normal ambient temperature to provide further evidence as to the importance of environmental factors on the intensity of MDMA's temperature effects. At normal ambient temperature, MDMA (10 mg/kg, i.p.) induced a significant brain and body hypothermia for the first 90 min following drug administration, and significantly increased heart rate and locomotor activity compared to saline controls. At high ambient temperature however, MDMA (10 mg/kg, i.p.) induced a robust and extended brain and body hyperthermia, as well as significantly increased heart rate and locomotor activity. A 3-day minocycline (50 mg/kg, i.p.) pre-treatment significantly attenuated MDMA-induced increases in brain temperature, body temperature, heart rate, and locomotor activity. Our findings indicate that minocycline is more effective in attenuating the exacerbated MDMA-induced hyperthermic response in the brain compared to the body at high ambient temperature.

Topics: Animals; Body Temperature; Brain; Fever; Heart Rate; Locomotion; Male; Minocycline; N-Methyl-3,4-methylenedioxyamphetamine; Rats; Rats, Sprague-Dawley

Topics: Acne Vulgaris; Adolescent; Diagnosis, Differential; Dose-Response Relationship, Drug; Drug Administration Schedule; Drug-Related Side Effects and Adverse Reactions; Female; Fever; Humans; Magnetic Resonance Imaging; Minocycline; Positron-Emission Tomography; Risk Factors; Sweating; Vasculitis; Weight Loss; Withholding Treatment

When animals suffer from viral infections, they develop a set of symptoms known as the "sickness response." Recent studies suggest that psychological stress can modulate the sickness response. However, it remains uncertain whether acute and chronic psychosocial stresses have the same effect on viral infection-induced sickness responses. To address this question, we compared changes in polyI:C-induced sickness responses, such as fever, change of body weight and food intake, mechanical allodynia, and depressive-like behavior, in rats that had been pre-exposed to single and repeated social defeat stresses. Intraperitoneal injection of polyI:C induced a maximal fever of 38.0°C 3h after injection. Rats exposed to prior social defeat stress exhibited blunted febrile responses, which were more pronounced in the repeated stress group. Furthermore, only the repeated stress group showed late-onset and prolonged mechanical allodynia lasting until 8days after injection in the von Frey test and prolonged immobility time in the forced swim test 9days post-injection. To assess the role of glucocorticoids and microglia in the delayed and persistent development of these sickness responses in rats exposed to repeated stress, we investigated the effect of pretreatment with RU486, a glucocorticoid receptor antagonist, and minocycline, an inhibitor of microglial activation, on polyI:C-induced allodynia and depressive-like behavior. Pretreatment with either drug inhibited both the delayed allodynia and depressive-like behavior. The present study demonstrates that repeated, but not single, social defeat stress followed by systemic polyI:C administration induced prolonged allodynia and depressive-like behavior in rats. Our results show that even though a single-event psychosocial stress does not have any effect by itself, animals may develop persistent allodynia and depressive-like behavior when they suffer from an infectious disease if they are pre-exposed to repeated or chronic psychosocial stress. Furthermore, this study suggests that stress-induced corticosterone and microglial activation play a pivotal role in this phenomenon.

Topics: Animals; Body Weight; Depression; Disease Models, Animal; Drug Administration Routes; Eating; Fever; Hormone Antagonists; Hyperalgesia; Interferon Inducers; Male; Mifepristone; Minocycline; Pain Management; Poly I-C; Rats; Rats, Long-Evans; Rats, Wistar; Stress, Psychological; Swimming; Time Factors

In this study, we describe a patient in whom tigecycline-induced drug fever and leukemoid reaction (LR) after 3 weeks of therapy for pneumonia.A 62-year-old man developed aspiration pneumonia on February 1, 2015. He had received multiple antibiotics at another hospital, but did not respond well. Disease rapidly progressed, and he was referred to our department on February 14. We adjusted the antibiotic therapy to tigecycline + vancomycin, and added voriconazole to empiric antifungal therapy. Pneumonia largely improved, and we discontinued vancomycin and voriconazole on February 28. With tigecycline monotherapy, his clinical status remained stable.On March 7, he developed high fever and LR (white blood cell count: 38.25 × 10(9)/L). Erythrocyte sedimentation rate and C-reactive protein were elevated, and CD8+ T cells had been abnormally activated. After a careful physical examination and laboratory investigation, we confirmed that primary infection did not progress and no other cause was evident. So we figured fever and LR might be induced by tigecycline. After discontinuing tigecycline and adding low-dose steroid, fever and LR totally resolved in 3 days, which further confirmed our diagnosis.According to this case and literature review, drug-induced hypersensitivity should be considered in the differential diagnosis of fever and LR when the therapeutic duration of tetracycline approximates 3 weeks. Monitoring T-cell subsets may facilitate early diagnosis. When necessary, we should discontinue the suspected drug to confirm diagnosis.

Topics: Anti-Bacterial Agents; Fever; Humans; Leukemoid Reaction; Male; Middle Aged; Minocycline; Pneumonia; Tigecycline

We report herein on two cases of Japanese spotted fever (JSF) treated with intravenous minocycline (MINO) and levofloxacin (LVFX). An 80 year-old woman (Case1) and a 63 year-old man (Case2) with high fever (> 39 degrees C) and wide-spread skin erythema were admitted because they were suspected of having developed JSF. After admission, we treated them with intravenous MINO and LVFX. The patients' fevers were resolved within 36 hours after antibiotics. They were diagnosed as having JSF based on the serological test, and Rickettsia japonica was detected from the genetic findings (PCR analysis from eschar) only in case 1. In the treatment of fulminant JSF (body temperature > 39 degrees C) the prompt administration of a combination of tetracycline and new quinolone has been recommended. The number of cases of JSF and its endemic area are gradually increasing in Japan. As for new quinolones, ciprofloxacin and tosufloxacin have been used against to JSF in Japan, but LVFX may become a new option.

Topics: Aged, 80 and over; Anti-Bacterial Agents; Drug Combinations; Female; Fever; Humans; Injections, Intravenous; Levofloxacin; Male; Middle Aged; Minocycline; Rickettsia Infections

Minocycline (MCN) is a member of the tetracycline family that is commonly used to treat dermatologic conditions such as acne and perioral dermatitis; however, it also has been associated with a number of adverse effects, including drug reaction with eosinophilia and systemic symptoms (DRESS). We report the case of a 46-year-old woman who developed a rash, fever, and eosinophilia during treatment with MCN for perioral dermatitis. Although MCN was discontinued and the patient was administered oral corticosteroids for several months, she subsequently died from multiorgan failure with giant cell myocardi-tis (GCM) and eosinophilic myocarditis found on autopsy. This article highlights a rare consequence of hypersensitivity to a commonly used drug and illustrates the importance of rapid recognition and aggressive management of MCN-induced DRESS.

Topics: Anti-Bacterial Agents; Dermatitis, Perioral; Drug Hypersensitivity Syndrome; Eosinophilia; Fatal Outcome; Female; Fever; Giant Cells; Humans; Middle Aged; Minocycline; Myocarditis

We report a case of Chlamydophila (C.) pneumoniae infection presenting with fever and rapid intrahepatic cholestasis. A 63-year-old man had a week-long history of intermittent high fever and rapidly progressive jaundice with atypical erythema. The results of liver function tests were recorded. The results of all serological tests were negative; the IgM, IgG, and IgA titers for C. pneumoniae had increased, which indicates a C. pneumoniae infection. The patient's fever and liver dysfunction improved upon administration of minocycline. Light microscopic findings showed the presence of enlarged liver cells with clear cytoplasm, a few mitotic figures, multinucleated cells, and bile cholestasis. The electron microscopic appearance of liver biopsy showed that bile canaliculi exhibited intrahepatic forms of cholestasis. From the results of light and electron microscopy, we inferred atypical intrahepatic cholestasis, probably resulting from the C. pneumoniae infection.

Topics: Alanine Transaminase; Anti-Bacterial Agents; Antibodies, Bacterial; Aspartate Aminotransferases; Chlamydophila Infections; Chlamydophila pneumoniae; Cholestasis, Intrahepatic; Erythema Nodosum; Fever; Humans; Jaundice, Obstructive; Liver; Lung; Male; Middle Aged; Minocycline

3,4-Methylenedioxymethamphetamine (MDMA, 'ecstasy') is a selective 5-HT neurotoxin in rat brain which has been shown to produce acute neuroinflammation characterized by activation of microglia and release of interleukin-1beta (IL-1beta). We aimed to determine whether or not minocycline, a semi-synthetic tetracycline antibiotic capable of inhibiting microglial activation, could prevent the inflammatory response and reduce the toxicity induced by MDMA. Adult male Dark Agouti rats were given minocycline twice a day for 2 days (45 mg/kg on the first day and 90 mg/kg on the second day; 12-h apart, i.p.). MDMA (12.5 mg/kg; i.p.) was given after the third minocycline injection and animals were killed either 1 h later for the determination of NFkappaB binding activity, 3 h later for the determination of IL-1beta, 24 h later for the determination of microglial activation or 7 days later for the determination of [(3)H]-paroxetine binding as a measure of 5-HT neurotoxicity. MDMA increased NFkappaB activation, IL-1beta release and microglial activation both in the frontal cortex and in the hypothalamus and 7 days later produced a reduction in the density of 5-HT uptake sites in both these brain areas. Minocycline prevented the MDMA-induced increase in NFkappaB activation, IL-1beta release and microglial activation in the frontal cortex and prevented the 5-HT neurotoxicity 7 days later. However, in the hypothalamus, in spite of preventing MDMA-induced microglial activation, minocycline failed to prevent MDMA-induced NFkappaB activation, IL-1beta release and neurotoxicity. This suggests that the protective mechanism of minocycline against MDMA-induced neurotoxicity in frontal cortex involves inhibition of MDMA-induced NFkappaB activation possibly through a reduction in IL-1beta signalling.

Topics: Animals; Drug Administration Schedule; Fever; Frontal Lobe; Hypothalamus; Inflammation; Interleukin-1beta; Male; Microglia; Minocycline; N-Methyl-3,4-methylenedioxyamphetamine; Neurons; Neuroprotective Agents; Neurotoxicity Syndromes; NF-kappa B; Paroxetine; Radioligand Assay; Rats; Rats, Inbred Strains; Serotonin; Serotonin Plasma Membrane Transport Proteins

Topics: Aged; Anti-Infective Agents, Local; Ceftriaxone; Erythema; Female; Fever; Humans; Minocycline; Ofloxacin; Povidone-Iodine; Rickettsia Infections; Severity of Illness Index; Treatment Outcome

Topics: Anti-Bacterial Agents; Antibodies; Asian People; Doxycycline; Exanthema; Female; Fever; Fluorescent Antibody Technique, Indirect; Humans; Kidney; Lupus Nephritis; Minocycline; Proteinuria; Time Factors; Urinalysis; Young Adult

A 64-year-old man visited our clinic with a 9-day history of headache and fever. He had frequent, severe, electric shock-like pain in his left eye, forehead, and scalp. The body temperature was 37.1 degrees. Cranial nerve functions were intact. Limb weakness and stiff neck were absent. There were injection of the conjunctiva, a red rash on the trunk, and an eschar in the axilla. Abnormal laboratory findings included AST 40 IU, ALT 44 IU, CRP 16.0 mg/dl, WBC 11,090/microl, and proteinuria. CT scan was unremarkable. The cerebrospinal fluid (CSF) showed 2 polymorphs/microl, 6 lymphocytes/microl, 65 mg/dl of glucose, and 42 mg/dl of protein. A diagnosis of scrub typhus was made. Treatment with minocycline brought about prompt disappearance of the fever and dramatic clinical improvement. Increased antibody titers confirmed the diagnosis. Although almost all patients present with high fever and severe headache, only a small number of patients have CSF pleocytosis. The present case illustrates that pain in scrub typhus is, on rare occasions, indistinguishable from trigeminal neuralgia. Neurologists should have a high index of suspicion in patients with fever and headache during the epidemic season and should be familiar with the systemic symptoms and signs.

Topics: Anti-Bacterial Agents; Diagnosis, Differential; Fever; Headache; Humans; Male; Middle Aged; Minocycline; Scrub Typhus; Treatment Outcome; Trigeminal Neuralgia

Tetracyclines induce anti-inflammatory effects unrelated to their antimicrobial activities. We investigated the effect induced by minocycline and doxycycline in models of nociceptive and inflammatory pain, edema, fever, cell migration and formation of fibrovascular tissue, as these effects have not been fully investigated. Tetracyclines were administered via intraperitoneal route 1 h before the tests. Minocycline and doxycycline (100 mg/kg) inhibited the second phase of the formalin-induced nociceptive response in mice. Doxycycline (100 mg/kg) also inhibited the first phase. The nociceptive response induced by phorbol 12,13-didecanoate (PDD) in mice was inhibited by doxycycline (100 mg/kg). Furthermore, carrageenan-induced mechanical allodynia in rats was inhibited by doxycycline and minocycline (50 or 100 mg/kg). However, they did not enhance the latency in the hot-plate test. It is unlikely that antinociception resulted from motor incoordination or muscle relaxing effect, as both tetracyclines (100 mg/kg) did not impair the motor activity of mice in the rota-rod test. Doxycycline (50 or 100 mg/kg) or minocycline (50 or 100 mg/kg) inhibited carrageenan-induced paw edema in rats. However, only minocycline (100 mg/kg) inhibited PDD-induced edema. Carrageenan-induced leukocyte migration into the peritoneal cavity of rats was inhibited by both tetracyclines (100 mg/kg). Endotoxin-induced fever in rats was also inhibited by doxycycline (50 or 100 mg/kg) or minocycline (100 mg/kg). Finally, formation of fibrovascular tissue induced by subcutaneous implant of a cotton pellet in mice was inhibited by a 6-day administration of both tetracyclines (50 or 100 mg/kg day). Concluding, this study clearly shows the antinociceptive and anti-inflammatory activities of these second-generation tetracyclines.

Topics: Analgesics; Animals; Anti-Bacterial Agents; Anti-Inflammatory Agents; Carrageenan; Doxycycline; Edema; Fever; Formaldehyde; Hot Temperature; Lipopolysaccharides; Male; Mice; Minocycline; Motor Activity; Pain; Phorbol Esters; Rats; Rats, Wistar

A 15-year-old Caucasian boy experienced severe fever, fatigue, and a 40-lb weight loss after 2 years of minocycline therapy. A workup for infectious causes was negative. One week after minocycline discontinuation, the patient reported that his fever had resolved. Two months later, he reported full resolution of symptoms, weight gain, and a return to normal activity. An objective causality assessment indicated that his illness probably was caused by minocycline, which is considered a safe drug; however, it has been associated with rare serious adverse effects. This patient's presentation of fever was noteworthy not only because minocycline is a rare cause of drug fever, but also because of the delayed onset. Clinicians should be aware that minocycline may cause severe fever and illness even after an extended period of drug exposure.

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Fever; Humans; Male; Minocycline; Time Factors

Topics: Adolescent; Anti-Bacterial Agents; Diagnosis, Differential; Exanthema; Female; Fever; Humans; IgA Vasculitis; Minocycline; Mucocutaneous Lymph Node Syndrome

Topics: Adolescent; Anti-Bacterial Agents; Female; Fever; Humans; IgA Vasculitis; Minocycline; Prednisolone

Topics: Acute Disease; Adult; Anti-Bacterial Agents; Fever; Hemoptysis; Hemorrhage; Humans; Kidney; Leg; Leptospirosis; Liver; Lung Diseases; Male; Minocycline; Muscle, Skeletal; Pain; Radiography, Thoracic; Respiratory Distress Syndrome; Tomography, X-Ray Computed

Topics: Adult; Anti-Bacterial Agents; Bone Marrow; Female; Fever; Humans; Liver; Lymphatic Diseases; Minocycline; Parotitis; Sezary Syndrome

Topics: Adverse Drug Reaction Reporting Systems; Anti-Bacterial Agents; Canada; Chemical and Drug Induced Liver Injury; Drug Eruptions; Eosinophilia; Fever; Humans; Lymphatic Diseases; Lymphocytosis; Minocycline

A 17-year-old female patient who had been taking oral minocycline (50 mg twice daily) for 3 weeks for acne developed an eruption that progressed to an exfoliative dermatitis. This illness was also characterized by fever, lymphadenopathy, pharyngitis, a leukemoid reaction, lymphocytosis, eosinophilia, hepatitis, and noncardiogenic pulmonary edema. Dramatic improvement followed institution of corticosteroid therapy. Studies for infectious and collagen vascular diseases were negative. This severe illness was likely caused by minocycline, and we speculate that minocycline may have acted as a superantigen, causing lymphocyte over-activation and massive cytokine release.

Topics: Acne Vulgaris; Adolescent; Anti-Bacterial Agents; Chemical and Drug Induced Liver Injury; Drug Eruptions; Eosinophilia; Female; Fever; Hematologic Diseases; Humans; Lymphocytosis; Minocycline

To describe a novel iatrogenic immunological reaction produced by minocycline.. The clinical course and laboratory results of three women who presented with similar rheumatological manifestations after a prolonged exposure to minocycline are described. All three presented a unique reaction manifested by fever, arthritis/arthralgia and livedo reticularis during treatment with minocycline for acne vulgaris. The clinical syndrome was associated with high titre of serum perinuclear anticytoplasmatic antibodies (p-ANCA) and antimyeloperoxidase antibody (anti-MPO). Symptoms resolved after stopping the drug and recurred promptly after rechallenge in all three patients.. Minocycline, which is widely used in the treatment of acne, often without adequate supervision, may induce arthritis and livedo vasculitis associated with anti-MPO.

Topics: Acne Vulgaris; Adult; Anti-Bacterial Agents; Antibodies, Antineutrophil Cytoplasmic; Arthritis; Autoantibodies; Biomarkers; Female; Fever; Humans; Minocycline; Peroxidase; Skin Diseases, Vascular

Minocycline is a tetracycline agent frequently used for acne therapy. It has a few rare but severe side effects that are not widely known but should be recognized early as drug related. These include acute hepatitis and liver failure; a Löffler-like syndrome with pulmonary infiltrates, wheezing, fever, and eosinophilia; skin eruptions, eosinophilic cellulitis, and pustular folliculitis with eosinophilia; and a lupuslike syndrome. Side effects that are better known and recognized include photosensitization, skin exanthema with pruritus, and pseudotumor cerebri.

Topics: Acne Vulgaris; Adult; Drug Eruptions; Drug Hypersensitivity; Eosinophilia; Female; Fever; Humans; Liver; Lymphatic Diseases; Minocycline; Neutropenia

A patient presenting with a pyrexial illness and transiently deranged liver function tests is described. He had been taking minocycline for 12 months. The causal association with this drug was demonstrated by withholding and then rechallenging with minocycline. This report documents drug fever as an adverse reaction to minocycline, and its late onset is of added interest.

Topics: Adult; Fever; Humans; Liver Function Tests; Male; Minocycline; Tetracyclines; Time Factors

Topics: Adult; Aged; Bacterial Infections; Diarrhea; Erythromycin; Female; Fever; Headache; Humans; Legionnaires' Disease; Male; Middle Aged; Minocycline; United States