Drug-induced hypersensitivity syndrome with high procalcitonin levels due to piperacillin/tazobactam and meropenem: A case report
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare and life-threatening adverse drug reaction. It is characterized by a long latency period with rash, hematological abnormalities, and visceral damage. Clinical manifestations of DRESS vary. Thus, accurate clinical diagnosis and i...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.951714/full |
| _version_ | 1811229791665258496 |
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| author | Gao Song Meng-Qun Cheng Rong Li Cai-Qiong Zhang Ping Sun |
| author_facet | Gao Song Meng-Qun Cheng Rong Li Cai-Qiong Zhang Ping Sun |
| author_sort | Gao Song |
| collection | DOAJ |
| description | Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare and life-threatening adverse drug reaction. It is characterized by a long latency period with rash, hematological abnormalities, and visceral damage. Clinical manifestations of DRESS vary. Thus, accurate clinical diagnosis and identification are essential to ensure timely treatment commencement for improving prognosis and speeding up recovery. We report the case of a 66-year-old male patient with a drug reaction induced by a beta-lactam antibiotic, piperacillin/tazobactam (Pip/Taz). This resulted in the manifestation of both eosinophilic and systemic symptoms. Ten days after the Pip/Taz treatment commencement, the patient developed hyperthermia and elevated serum procalcitonin (PCT), leading to a misdiagnosis of an exacerbated infection. Meropenem treatment was then started. However, after 72 h, the patient developed a generalized rash, eosinophilia, hematological abnormalities, and visceral damage. Moreover, PCT levels were significantly elevated. All these symptoms were associated with DRESS. The sensitizing drug was discontinued, and glucocorticoids were administered, resulting in gradual subsiding of symptoms and decreases in serum PCT levels. Clinicians should be aware that elevated PCT serum levels may be a diagnostic biomarker for DRESS, which requires specific treatment. Furthermore, studies are warranted to further evaluate and elucidate the role of PCT in response to DRESS. |
| first_indexed | 2024-04-12T10:18:58Z |
| format | Article |
| id | doaj.art-2fcb0ac0f5f842fcbca3e7440fa3f12a |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-12T10:18:58Z |
| publishDate | 2022-10-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-2fcb0ac0f5f842fcbca3e7440fa3f12a2022-12-22T03:37:08ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-10-01910.3389/fmed.2022.951714951714Drug-induced hypersensitivity syndrome with high procalcitonin levels due to piperacillin/tazobactam and meropenem: A case reportGao Song0Meng-Qun Cheng1Rong Li2Cai-Qiong Zhang3Ping Sun4Department of Pharmacy, The Puer People's Hospital of Yunna City, Puer, ChinaDepartment of Reproductive Medicine, The Puer People's Hospital of Yunna City, Puer, ChinaDepartment of Pharmacy, The Puer People's Hospital of Yunna City, Puer, ChinaDepartment of Pharmacy, The Puer People's Hospital of Yunna City, Puer, ChinaDepartment of Science Education, The Puer People's Hospital of Yunna City, Puer, ChinaDrug reaction with eosinophilia and systemic symptoms (DRESS) is a rare and life-threatening adverse drug reaction. It is characterized by a long latency period with rash, hematological abnormalities, and visceral damage. Clinical manifestations of DRESS vary. Thus, accurate clinical diagnosis and identification are essential to ensure timely treatment commencement for improving prognosis and speeding up recovery. We report the case of a 66-year-old male patient with a drug reaction induced by a beta-lactam antibiotic, piperacillin/tazobactam (Pip/Taz). This resulted in the manifestation of both eosinophilic and systemic symptoms. Ten days after the Pip/Taz treatment commencement, the patient developed hyperthermia and elevated serum procalcitonin (PCT), leading to a misdiagnosis of an exacerbated infection. Meropenem treatment was then started. However, after 72 h, the patient developed a generalized rash, eosinophilia, hematological abnormalities, and visceral damage. Moreover, PCT levels were significantly elevated. All these symptoms were associated with DRESS. The sensitizing drug was discontinued, and glucocorticoids were administered, resulting in gradual subsiding of symptoms and decreases in serum PCT levels. Clinicians should be aware that elevated PCT serum levels may be a diagnostic biomarker for DRESS, which requires specific treatment. Furthermore, studies are warranted to further evaluate and elucidate the role of PCT in response to DRESS.https://www.frontiersin.org/articles/10.3389/fmed.2022.951714/fullβ-lactam antibioticsPCTpiperacillin/tazobactammeropenemDIHSDRESS |
| spellingShingle | Gao Song Meng-Qun Cheng Rong Li Cai-Qiong Zhang Ping Sun Drug-induced hypersensitivity syndrome with high procalcitonin levels due to piperacillin/tazobactam and meropenem: A case report Frontiers in Medicine β-lactam antibiotics PCT piperacillin/tazobactam meropenem DIHS DRESS |
| title | Drug-induced hypersensitivity syndrome with high procalcitonin levels due to piperacillin/tazobactam and meropenem: A case report |
| title_full | Drug-induced hypersensitivity syndrome with high procalcitonin levels due to piperacillin/tazobactam and meropenem: A case report |
| title_fullStr | Drug-induced hypersensitivity syndrome with high procalcitonin levels due to piperacillin/tazobactam and meropenem: A case report |
| title_full_unstemmed | Drug-induced hypersensitivity syndrome with high procalcitonin levels due to piperacillin/tazobactam and meropenem: A case report |
| title_short | Drug-induced hypersensitivity syndrome with high procalcitonin levels due to piperacillin/tazobactam and meropenem: A case report |
| title_sort | drug induced hypersensitivity syndrome with high procalcitonin levels due to piperacillin tazobactam and meropenem a case report |
| topic | β-lactam antibiotics PCT piperacillin/tazobactam meropenem DIHS DRESS |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.951714/full |
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