medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2025-095medsovet-8984Research ArticleШКОЛА ПЕДИАТРАPEDIATRICIAN SCHOOLЛекарственные лихорадки и гипертермииDrug fever and hyperthermiahttps://orcid.org/0000-0002-4060-9692ГудковР. А.GudkovR. A.

Гудков Роман Анатольевич - к.м.н., доцент, доцент кафедры детских болезней с курсом госпитальной педиатрии.

390036, Рязань, ул. Высоковольтная, д. 9

Roman A. Gudkov - Cand. Sci. (Med.), Associate Professor, Associate Professor of Department of Children's Diseases with Hospital Paediatrics Course.

9, Vysokovoltnaya St., Ryazan, 390013

comancherro@mail.ruhttps://orcid.org/0000-0002-3915-2242БлоховаЕ. Э.BlokhovaE. E.

Блохова Екатерина Эдуардовна - к.м.н., доцент кафедры детских болезней с курсом госпитальной педиатрии.

390036, Рязань, ул. Высоковольтная, д. 9

Ekaterina E. Blokhova - Cand. Sci. (Med.), Associate Professor of Department of Children's Diseases with Hospital Paediatrics Course.

9, Vysokovoltnaya St., Ryazan, 390013

kirieshka@mail.ruhttps://orcid.org/0000-0002-8202-3876ДмитриевА. В.DmitrievA. V.

Дмитриев Андрей Владимирович - д.м.н., профессор, заведующий кафедрой детских болезней с курсом госпитальной педиатрии.

390036, Рязань, ул. Высоковольтная, д. 9

Andrey V. Dmitriev - Dr. Sci. (Med.), Professor, Head of Department of Children's Diseases with Hospital Paediatrics Course.

9, Vysokovoltnaya St., Ryazan, 390013

aakavd@yandex.ruhttps://orcid.org/0000-0003-1303-8318ЗаплатниковА. Л.ZaplatnikovA. L.

Заплатников Андрей Леонидович - д.м.н., профессор, заведующий кафедрой неонатологии имени профессора В.В. Гаврюшова, профессор кафедры педиатрии имени академика Г.Н. Сперанского.

123995, Москва, ул. Баррикадная, д. 2/1, стр. 1

Andrey L. Zaplatnikov - Dr. Sci. (Med.), Professor, Head of Department of Neonatology named after Prof. V.V. Gavryushov, Professor of Department of Paediatrics named after Acad. G.N. Speransky.

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993

zaplatnikov@mail.ruРязанский государственный медицинский университет имени академика И.П. ПавловаРоссияRyazan State Medical University named after Academician I.P. PavlovRussian FederationРоссийская медицинская академия непрерывного профессионального образованияРоссияRussian Medical Academy of Continuous Professional EducationRussian Federation20250504202501214220Copyright © Гудков Р.А., Блохова Е.Э., Дмитриев А.В., Заплатников А.Л., 20252025Гудков Р.А., Блохова Е.Э., Дмитриев А.В., Заплатников А.Л.Gudkov R.A., Blokhova E.E., Dmitriev A.V., Zaplatnikov A.L.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/8984

Лекарственная лихорадка – это фебрильная реакция, по времени совпадающая и патогенетически связанная с применением лекарственного средства. В обзоре представлены публикации эпидемиологических и клинических исследований, касающихся разнообразных вариантов развития лихорадки вследствие применения фармакологических средств. Рассмотрены лихорадочные реакции, связанные как с иммунной гиперчувствительностью, так и имеющие другие механизмы развития, а также синдромы лекарственной гиперчувствительности, включающие лихорадку как один из синдромов (синдром лекарственно-индуцированной гиперчувствительности, сывороточная болезнь, лекарственная волчанка). Наиболее часто термин «лекарственная лихорадка» используется для определения случаев с изолированным фебрильным повышением температуры тела, не сопровождающихся другими клиническими симптомами, например сыпью или органными поражениями, и имеющих иммунный генез. Установлена связь лекарственной лихорадки с чрезвычайно широким спектром лекарственных средств, но наиболее часто она вызывается бета-лактамными антибиотиками. Высокая вероятность развития лекарственной лихорадки у пациентов отделения реанимации и интенсивной терапии, имеющих высокий риск бактериальной инфекции и получающих длительные курсы антибиотиков. Гиподиагностика лекарственной лихорадки приводит к необоснованному продолжению и усилению антибактериальной терапии, повышению риска ятрогенных осложнений и экономических затрат. Также в обзоре представлены варианты лекарственных гипертермий: злокачественный нейролептический синдром, злокачественная гипертермия, серотониновый синдром, синдром инфузии пропофола и некоторые другие. Несмотря на давнюю историю изучения вопроса, патогенез патологии остается до сих пор непонятным, что не позволяет разработать эффективные методы распознавания, отсутствуют специфические диагностические маркеры и диагноз по-прежнему ставится методом исключения.

Drug fever is a febrile reaction that coincides in time with and is pathogenetically associated with the use of a drug. The review presents publications of epidemiological and clinical studies on various variants of fever development due to the use of pharmacological agents. Febrile reactions associated with both immune hypersensitivity and those with other mechanisms of development, as well as drug hypersensitivity syndromes, including fever as one of the syndromes (drug-induced hypersensitivity syndrome, serum sickness, drug-induced lupus), are considered. Most often, the term “drug fever” is used to define cases with isolated febrile increase in body temperature, not accompanied by other clinical symptoms (for example, rash or organ damage), and having an immune genesis. An association of drug fever with an extremely wide range of drugs has been established, but most often it is caused by beta-lactam antibiotics. There is a high probability of drug fever in intensive care unit patients who have a high risk of bacterial infection and receive long courses of antibiotics. Underdiagnosis of drug fever leads to unjustified continuation and intensification of antibacterial therapy, increased risk of iatrogenic complications and economic costs. The review also presents variants of drug hyperthermia: malignant neuroleptic syndrome, malignant hyperthermia, serotonin syndrome, propofol infusion syndrome and some others. Despite the long history of studying the issue, the pathogenesis of the pathology remains not entirely clear, there are no specific diagnostic markers and the diagnosis is still made by exclusion.

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The authors declare that there are no conflicts of interest present.