To the Editor.—
Sulindac (Clinoril) is a nonsteroidal anti-inflammatory drug used for the treatment of arthritic disorders. Several reports of adverse reactions, such as marrow aplasia,1 hepatotoxicity,2 and hypersensitivity,3,4 have been noted. We report a case of hypersensitivity, manifested primarily by an acute febrile reaction that mimicked an infectious process.
Report of a Case.—
A 52-year-old man had a history of mitral commissurotomy and implantation of a demand pacemaker six months ago. He was admitted to St Francis Hospital, Trenton, NJ, with a ten-day history of fever, chills, and malaise. The patient appeared acutely ill, febrile (40.3 °C), and hypotensive (blood pressure, 90/70 mm Hg). There was nail and lip cyanosis. Cardiovascular examination revealed a grade 3/6 pansystolic murmur at the apex. The initial impression was of bacterial endocarditis, and after appropriate blood cultures, therapy was started with penicillin and streptomycin. He became afebrile within 36 hours.
Levites R, Hafitz G, Kirubakaran M. Febrile Reaction to Sulindac. JAMA. 1981;246(3):213-214. doi:10.1001/jama.1981.03320030011009