{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:22:58Z","timestamp":1791559378221,"version":"4.3.4"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":223,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001652","name":"Friedrich-Alexander-Universit\u00e4t Erlangen-N\u00fcrnberg","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001652","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Critical Care"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Although beta\u2010lactam antibiotics are widely used in intensive care, rare but potentially fatal anaphylactic reactions can occur due to cross\u2010reactions between penicillins and cephalosporins. We report the case of a 68\u2010year\u2010old man who suffered perioperative cardiac arrest following the administration of cefuroxime. During the postoperative period, the patient received ampicillin\/sulbactam without any signs of hypersensitivity. Following a switch to piperacillin\/tazobactam prior to a procedure, the patient suddenly developed cardiovascular arrest and died. The autopsy revealed no macroscopic cause of death, but immunohistochemistry showed mast cell degranulation (\u201cstarry sky pattern\u201d) in the tissue, suggesting anaphylaxis. We present the clinical and histopathological findings of a case with severe allergic reactions to both cefuroxime and piperacillin\/tazobactam, as a result of either cross\u2010reaction or isolated sensitization to both antibiotics. This case report highlights the potential risks of cross\u2010reactivity between beta\u2010lactam antibiotics and the importance of autopsy in ambiguous cases. Clinicians should be aware of cross\u2010reactivity or cosensitization to multiple beta\u2010lactams in patients with a beta\u2010lactam allergy and consider non\u2013beta\u2010lactam alternatives in high\u2010risk cases.<\/jats:p>","DOI":"10.1155\/crcc\/6339253","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T11:41:46Z","timestamp":1786534906000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Anaphylactic Shock Probably due to a Cross\u2010Reaction Between Cefuroxime and Piperacillin\u2014Presentation of a Fatal Case, Diagnostic Considerations, and Literature Review"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-0633-1728","authenticated-orcid":false,"given":"August","family":"Fiegl","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4860-4626","authenticated-orcid":false,"given":"Arndt","family":"Hartmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"F\u00fchrling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8125-0690","authenticated-orcid":false,"given":"Niklas","family":"Carbon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1958-9364","authenticated-orcid":false,"given":"Roland C. 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