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Rafael Levites, MD; George Hafitz, MD; Munuswany Kirubakaran, MD
St Francis Medical Center Trenton, NJ Hahnemann Medical College Philadelphia

JAMA. 1981;246(3):213-214.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

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. . . . [Full Text PDF of this Article]

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