βラクタム系抗生物質による薬剤熱を認めた急性腎盂腎炎

Drug-induced fever after using beta-lactam antibiotics for urinary tract infection

　60歳女性が左側背部痛と発熱を訴えて受診した。CTで左水腎症と左尿管結石を認めた。尿管ステントを留置し，塩酸セフォチアムを投与した。全身状態の改善にかかわらず発熱が持続した。理学所見，検査所見，臨床経過から薬剤熱と診断した。泌尿器科領域では薬剤熱は一般的とはいいがたく，急性腎盂腎炎での抗生物質投与時にはその診断に難渋する。考察を加え報告する。

The patient, a 60-year-old female, presented complaining of left flank pain and fever elevation. CT revealed left hydronephrosis and left ureteral stone. The placement of ureteral stent was performed and cefotiam hydrochloride was given. Even though her general condition became improved, a high fever was continued. After numerous examinations, she was diagnosed as drug-induced fever. It was very difficult to reach this diagnosis in this patient. We report this case with some suggestions, since drug-induced fever is not common in urology department.