A. and MOTOMIYA, M. Clinical Study of Drug Fever Induced by Parenteral Administration of Antibiotics. Tohoku J. Exp. Med., 1989, 159 (1), [45][46][47][48][49][50][51][52][53][54][55][56] The incidence and clinical features of drug fever induced by antibiotics were investigated. Of a total of 390 patients analyzed, 193 had malignant diseases (lung cancer in most cases) and the remaining 197 had non-malignant diseases, of which the majority comprised pulmonary infectious diseases such as pneumonia, lung abscess and chronic infections. Q-Lactams most frequently induced drug fever. Piperacillin induced drug fever in 18 of 108 (17%), cefotaxime in 11 of 72 (15%), ceftizoxime in 7 of 49 (14%) and cefoperazone in 6 of 74 patients (8%). In contrast, the incidence of drug fever caused by ampicillin and that by cefazolin were in one of 39 (3%) and in none of 44 (0%), respectively. On the other hand, antimicrobial agents other than /l-lactams only rarely induced drug fever. The higher incidence of drug fever caused by newer derivatives of f3-lactam antibiotic suggests that the side chain attached to their core moiety might be involved in the mechanism of drug fever. In patients with malignancy who were on antibiotics, respiratory infection was the most frequent cause of fever exceeding 38°C. In contrast, in patients with non-malignant diseases, the use of antibiotic per se was the most frequent cause of the fever which reccurred during antibiotic therapy after a previous febrile episode had subsided. The most common feature of drug fever induced by the use of an antibiotic was as follows : A low-grade fever at the time of onset is followed by a high and remittent fever. The highest diurnal body temperature rises gradually, and then the fever subsides promptly after cessation of the causative antibiotic. The fever of this type accounted for 70% of all the drug fever in this study. A transient elevation of serum level of lactic dehydrogenase was associated with drug fever in one half (25/49, 51%) of the patients. A transient and slight decrease from the normal range in counts of neutrophils and platelets were observed in 11(23%) and in 4 (8%) of 48 patients with drug fever, respectively. These changes in laboratory findings were considered as the possible consequence of allergic processes involved in the development of drug fever and thus seem to be a helpful index for establishing the diagnosis of drug fever, drug-induced fever ; Q-lactam antibiotics ; neutrophil ; lactate dehydrogenase

A 67-year-old female was emergently admitted to our hospital because of severe dyspnea with cyanosis. One month before admission, she consulted a doctor and chest x-ray disclosed a huge tumor shadow occupying most of the left hemithorax. At that time, she did not complain of any particular symptoms except slight cough. Twelve days after admission, the patient lost consciousness and an emergency operation was performed. The tumor showed severe adhesion to the aorta and the lower lobe of the left lung, but not to the esophagus. After the operation, mechanical ventilation was necessary for 13 days to recover pulmonary function. Histological diagnosis was made as leiomyoma, which is rarely seen in the mediastinal region. At present, the patient survived 10 years without any symptom of recurrence. In this paper, the authors report a case of mediastinal leiomyoma which received an emergency operation and attained long term survival. Twelve similar cases reported in the past were also reviewed. mediastinal leiomyoma ; emergency operation ; long-term survivalMediastinal masses have interesting diagnostic and therapeutic problems for the clinician.Recent advances in radiographic, surgical and anesthesia tech niques have improved clinical understanding and therapeutic results for medias tinal tumors. However, there are still considerable cases that definite diagnosis is difficult before surgery. Leiomyoma of mediastinum origin is quite rare in incidence (Morrison 1958 ;Petrikova 1982). Clinical features, including initial symptoms, radiographic appearance, and therapeutic results are still unclear. In this paper, the authors report a case with giant mediastinal leiomyoma which received an emergency operation and attained long-term disease-free survival.There were 12 cases of mediastinal leiomyoma reported in the literature, 7 from other countries and 5 from Japan (Nishimoto et al. 1957;Rasaretnam and Panabokke 1975;Suzuki et al. 1982).

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For objective evaluation of the efficacy and safety of ceftazidime (CAZ), a new cephem antibiotic, in respiratory tract infections, a double blind comparative study was carried out against cefotiam (CTM). Either of the drugs was administered by intravenous drip infusion in the unit dose of 1 g (potency) twice daily for 14 days, and the following results were obtained.

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