{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T22:52:53Z","timestamp":1761864773355,"version":"build-2065373602"},"reference-count":14,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,10,6]]},"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>Drug-induced fever is an uncommon but important differential in patients with unexplained fever. We present a case of a woman in her 60s with advanced renal disease and recent total hip arthroplasty who developed fever after an extended course of ciprofloxacin treatment. Extensive investigations, including cultures, imaging and orthopaedic review, failed to identify an infectious source. Although her fever initially resolved by day 2, it recurred on day 19 of treatment. Repeat assessments remained inconclusive. Ciprofloxacin-induced drug fever was suspected, and defervescence occurred within 48 hours of discontinuation, with no recurrence thereafter. This case highlights the importance of considering drug fever once other causes have been excluded. Early recognition can prevent unnecessary antibiotic escalation, reduce hospital stay and improve patient outcomes. Clinicians should maintain a high index of suspicion for this diagnosis, particularly when new medications coincide with unexplained fever in the absence of clear infection.<\/jats:p>","DOI":"10.1136\/bcr-2025-266982","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T11:15:27Z","timestamp":1760699727000},"page":"e266982","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Ciprofloxacin-induced drug fever"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-4825-5608","authenticated-orcid":false,"given":"Wilson","family":"Lim","sequence":"first","affiliation":[{"name":"Geriatric Medicine, Surrey and Sussex Healthcare NHS Trust, Redhill, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"2025101704151614000_18.10.e266982.1","doi-asserted-by":"crossref","first-page":"95","DOI":"10.37737\/ace.23013","article-title":"Drug fever: a narrative review","volume":"5","author":"Someko","year":"2023","journal-title":"Ann Clin Epidemiol"},{"key":"2025101704151614000_18.10.e266982.2","doi-asserted-by":"publisher","DOI":"10.1592\/phco.30.1.57"},{"key":"2025101704151614000_18.10.e266982.3","doi-asserted-by":"publisher","DOI":"10.1007\/BF03261972"},{"key":"2025101704151614000_18.10.e266982.4","first-page":"57","article-title":"Drug fever associated with ciprofloxacin in a cirrhotic patient with hepatocellular carcinoma","volume":"17","author":"Su","year":"2009","journal-title":"Formosa J Clin Pharm"},{"key":"2025101704151614000_18.10.e266982.5","doi-asserted-by":"crossref","unstructured":"Sheldon J , Wheeler RD , Riches PG . 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Academic Press, 2006: 923\u201362.","DOI":"10.1016\/B978-012088451-3\/50030-2"},{"key":"2025101704151614000_18.10.e266982.8","doi-asserted-by":"crossref","DOI":"10.1177\/2050313X231177108","article-title":"Typhoid fever, complicated by syncope due to relative bradycardia: A case report","volume":"11","author":"Nguyen","year":"2023","journal-title":"SAGE Open Med Case Rep"},{"key":"2025101704151614000_18.10.e266982.9","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.31.5.709"},{"key":"2025101704151614000_18.10.e266982.10","unstructured":"Joint Formulary Committee . British national formulary. 2024. Available: https:\/\/bnf.nice.org.uk\/drugs\/ciprofloxacin\/ (Accessed [Accessed 19 Jul 2025]."},{"key":"2025101704151614000_18.10.e266982.11","doi-asserted-by":"publisher","DOI":"10.2165\/11531490-000000000-00000"},{"key":"2025101704151614000_18.10.e266982.12","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1007\/s40800-018-0073-4","article-title":"Nephrotoxicity of Ciprofloxacin: Five Cases and a Review of the Literature","volume":"5","author":"Hajji","year":"2018","journal-title":"Drug Saf Case Rep"},{"key":"2025101704151614000_18.10.e266982.13","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2001.060002804.x"},{"key":"2025101704151614000_18.10.e266982.14","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1981.154"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-266982","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T11:15:30Z","timestamp":1760699730000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-266982"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":14,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10,17]]},"published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1136\/bcr-2025-266982"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-266982","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]}}}