The use of ''unconventional'' or alternative medicine has been reporte
d in up to one third of American households, yet only 28% report the u
se of such agents to their physician. We present here a case of near f
atal sepsis and agranulocytosis. The agranulocytosis is attributed to
the use of dipyrone (Dolo-Tiaminol), which the patient obtained in Mex
ico as a stronger form of generic ''aspirin.'' The pyrazolone class of
analgesics, of which dipyrone is a derivative, was introduced in the
late 19th century and had a meteoric rise in use until an associated r
ise in fatal agranulocytosis was discovered. These agents were banned
by the Food and Drug Administration (FDA) in 1977. Dipyrone is thought
to induce agranulocytosis by inducing an antibody response. With the
widespread use of alternative treatments, it is important for physicia
ns to inquire as to the use of unprescribed drugs, Several resources a
re available to aid with the identification of foreign drugs.