We present the case of a 77-year-old woman who initially presented wit
h pyrexia of unknown origin, anaemia and mild renal impairment. When h
er omeprazole was stopped she improved rapidly. When omeprazole was re
-started she developed fever and acute renal failure, which again sett
led quickly on discontinuation of omeprazole. This case demonstrates h
ow drugs can cause severe multisystem disorders that may appear to be
infective or inflammatory.