title: Hyperpyrexia, allergic-type response and death occurring with low-dose bleomycin administration.
abstract: This is a case report of hyperpyrexia, shock and death following initial injection of low-dose bleomycin (7.5 units) for a poorly differentiated metastatic carcinoma. Premedication with high-dose dexamethasone and acetaminophen did not abort the reaction. A review of the literature uncovered one nearly fatal reaction to a test dose of 1 unit of bleomycin All previously reported fatal cases were in patients with lymphoma who had received an initial dose of at least 25 units/m2. Since the 'safe' test dose of bleomycin is not known, test doses of 1 unit or lower should be routinely used; the effect of premedication is also unclear.
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000368:Aged; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects*; D003907:Dexamethasone / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004342:Drug Hypersensitivity / Q000209:etiology*; D004359:Drug Therapy, Combination; D005334:Fever / Q000139:chemically induced*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D009182:Mycosis Fungoides / Q000188:drug therapy; D009362:Neoplasm Metastasis; D011292:Premedication; D012878:Skin Neoplasms / Q000188:drug therapy
chemical_list: D001761:Bleomycin; D000082:Acetaminophen; D003907:Dexamethasone