Tacrolimus-Induced Fever in a Patient Undergoing Kidney Transplantation

Tacrolimus is widely used with other immunosuppressive agents to prevent rejection of a kidney transplant (KT).However, tacrolimus-induced fever is very rarely diagnosed.We report a case of tacrolimus-induced fever after KT.A 53-year-old female was diagnosed with cytomegalovirus (CMV) viremia.She had received a KT 2 months previously.Ganciclovir was started immediately at that time.A fever developed on day 12 of admission.Because of dysuria and a residual urine sensation with pyuria, we started intravenous antibiotics to treat urinary tract infection.Although other infectious reasons were ruled out and CMV viremia and the urinary tract infection improved, the fever spike did not improve.Thus, we suspected drug-induced fever.First, the ganciclovir and antibiotics were discontinued.However, the fever continued.To exclude tacrolimus-induced fever, tacrolimus was discontinued and cyclosporine was used with other immunosuppressive agents.Tacrolimus was discontinued after 1 day and the fever was no longer confirmed.(