Morphine-induced fever: a case report and review of the literature.
Case report
Drug fever
Hypersensitivity
Morphine
Opioids
Journal
Journal of medical case reports
ISSN: 1752-1947
Titre abrégé: J Med Case Rep
Pays: England
ID NLM: 101293382
Informations de publication
Date de publication:
27 Sep 2024
27 Sep 2024
Historique:
received:
03
04
2024
accepted:
22
08
2024
medline:
27
9
2024
pubmed:
27
9
2024
entrez:
26
9
2024
Statut:
epublish
Résumé
Morphine is widely used to treat moderate-to-severe cancer pain. However, it causes various adverse effects, with morphine-induced fever being an extremely rare and poorly understood symptom. We report the case of a 58-year-old Chinese woman with advanced lung cancer. Due to the ineffectiveness of tramadol for pain relief, her treatment regimen was switched to morphine. Following the change, she developed nausea, vomiting, dizziness, and elevated body temperature. A similar episode occurred subsequently. After a drug review, the pharmacist speculated that morphine was the most likely causative agent. Upon discontinuation of morphine, her body temperature returned to baseline levels. This case highlights the need for healthcare providers to consider morphine as a potential cause of unexplained fever in patients. The fever may be caused by a hypersensitive response, as there was a significant increase in eosinophils during the fever episodes.
Sections du résumé
BACKGROUND
BACKGROUND
Morphine is widely used to treat moderate-to-severe cancer pain. However, it causes various adverse effects, with morphine-induced fever being an extremely rare and poorly understood symptom.
CASE PRESENTATION
METHODS
We report the case of a 58-year-old Chinese woman with advanced lung cancer. Due to the ineffectiveness of tramadol for pain relief, her treatment regimen was switched to morphine. Following the change, she developed nausea, vomiting, dizziness, and elevated body temperature. A similar episode occurred subsequently. After a drug review, the pharmacist speculated that morphine was the most likely causative agent. Upon discontinuation of morphine, her body temperature returned to baseline levels.
CONCLUSIONS
CONCLUSIONS
This case highlights the need for healthcare providers to consider morphine as a potential cause of unexplained fever in patients. The fever may be caused by a hypersensitive response, as there was a significant increase in eosinophils during the fever episodes.
Identifiants
pubmed: 39327606
doi: 10.1186/s13256-024-04770-2
pii: 10.1186/s13256-024-04770-2
doi:
Substances chimiques
Morphine
76I7G6D29C
Analgesics, Opioid
0
Tramadol
39J1LGJ30J
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
449Subventions
Organisme : Natural Science Foundation of Chongqing Municipality
ID : CSTB2022NSCQ-MSX0069
Organisme : Medical Scientific Research Project of Chongqing Health Commission
ID : 2024WSJK015
Informations de copyright
© 2024. The Author(s).
Références
Patel RA, Gallagher JC. Drug fever. Pharmacotherapy. 2010;30(1):57–69.
doi: 10.1592/phco.30.1.57
pubmed: 20030474
Graczyk M, Krajnik M, Woroń J, Wordliczek J, Malec-Milewska M. Use of opioids as one of the causes of fever in patients with advanced cancer. Int J Immunopathol Pharmacol. 2017;30(1):98–104.
doi: 10.1177/0394632016686088
pubmed: 28059575
pmcid: 5806778
Bhagat M, Suman S, Besra KC, et al. Morphine-induced fever: a case series. Cureus. 2022;14(4): e24402.
pubmed: 35481239
pmcid: 9034657
Johnson DH, Cunha BA. Drug fever. Infect Dis Clin North Am. 1996;10(1):85–91.
doi: 10.1016/S0891-5520(05)70287-7
pubmed: 8698996
Vodovar D, LeBeller C, Mégarbane B, Lillo-Le-Louet A, Hanslik T. Drug fever: a descriptive cohort study from the French national pharmacovigilance database. Drug Saf. 2012;35(9):759–67.
doi: 10.1007/BF03261972
pubmed: 22830618
Murayama H, Sakuma M, Takahashi Y, Morimoto T. Improving the assessment of adverse drug reactions using the Naranjo algorithm in daily practice: the Japan adverse drug events study. Pharmacol Res Perspect. 2018;6(1): e00373.
doi: 10.1002/prp2.373
pubmed: 29417762
pmcid: 5817823
Belén Rivas A, Arruza L, Pacheco E, Portoles A, Diz J, Vargas E. Adverse drug reactions in neonates: a prospective study. Arch Dis Child. 2016;101(4):371–6.
doi: 10.1136/archdischild-2015-309396
pubmed: 26819267
Petrova G, Stoimenova A, Dimitrova M, Kamusheva M, Petrova D, Georgiev O. Assessment of the expectancy, seriousness and severity of adverse drug reactions reported for chronic obstructive pulmonary disease therapy. SAGE Open Med. 2017;5:2050312117690404.
doi: 10.1177/2050312117690404
pubmed: 28228952
pmcid: 5308439
Ryan KF, Price JW, Warriner CB, Choi PT. Persistent hypothermia after intrathecal morphine: case report and literature review. Can J Anaesth. 2012;59(4):384–8.
doi: 10.1007/s12630-011-9650-z
pubmed: 22161244
Ferraz S, Caria T, Da Silva AV, Candeias MJ, Cenicante T. Persistent hypothermia and excessive sweating following intrathecal morphine administration in a teenage boy: a case report. Anesth Pain Med. 2018;8(1): e66724.
pubmed: 29868463
pmcid: 5970363
Baker AK, Meert TF. Functional effects of systemically administered agonists and antagonists of mu, delta, and kappa opioid receptor subtypes on body temperature in mice. J Pharmacol Exp Ther. 2002;302(3):1253–64.
doi: 10.1124/jpet.102.037655
pubmed: 12183687
Fischer MO, Dequiré PM, Kalem A, Gérard JL, Plaud B. Hypothermia after spinal anaesthesia: implication of morphine? Ann Fr Anesth Reanim. 2006;25(3):296–8.
doi: 10.1016/j.annfar.2005.09.009
pubmed: 16377124
Koek W, France CP, Javors MA. Morphine-induced motor stimulation, motor incoordination, and hypothermia in adolescent and adult mice. Psychopharmacology. 2012;219(4):1027–37.
doi: 10.1007/s00213-011-2432-z
pubmed: 21837433
Vezina P, Stewart J. Hyperthermia induced by morphine administration to the VTA of the rat brain: an effect dissociable from morphine-induced reward and hyperactivity. Life Sci. 1985;36(11):1095–105.
doi: 10.1016/0024-3205(85)90495-3
pubmed: 2983167
Clark WG. Influence of opioids on central thermoregulatory mechanisms. Pharmacol Biochem Behav. 1979;10(4):609–13.
doi: 10.1016/0091-3057(79)90241-7
pubmed: 223174
Chen X, McClatchy DB, Geller EB, Liu-Chen L, Tallarida RJ, Adler MW. Possible mechanism of hypothermia induced by intracerebroventricular injection of orphanin FQ/nociceptin. Brain Res. 2001;904(2):252–8.
doi: 10.1016/S0006-8993(01)02467-2
pubmed: 11406123
Spencer RL, Hruby VJ, Burks TF. Body temperature response profiles for selective mu, delta and kappa opioid agonists in restrained and unrestrained rats. J Pharmacol Exp Ther. 1988;246(1):92–101.
pubmed: 2839673
Spencer RL, Hruby VJ, Burks TF. Alteration of thermoregulatory set point with opioid agonists. J Pharmacol Exp Ther. 1990;252(2):696–705.
pubmed: 2313595
Vidal C, Pérez-Leiros P, Bugarín R, Armisén M. Fever and urticaria to codeine. Allergy. 2000;55(4):416–7.
doi: 10.1034/j.1398-9995.2000.00556.x
pubmed: 10782540
Enomoto M, Ochi M, Teramae K, Kamo R, Taguchi S, Yamane T. Codeine phosphate-induced hypersensitivity syndrome. Ann Pharmacother. 2004;38(5):799–802.
doi: 10.1345/aph.1D528
pubmed: 15010521
Xiao J, Jia SJ, Wu CF. Celecoxib-induced drug fever: a rare case report and literature review. J Clin Pharm Ther. 2022;47(3):402–6.
doi: 10.1111/jcpt.13490
pubmed: 34287995