{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T10:42:40Z","timestamp":1792233760102,"version":"4.4.0"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"vor","delay-in-days":289,"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"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Immunology"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Adult\u2010onset Still\u2019s disease (AOSD) is a diagnosis of exclusion and may be difficult to recognize when infection and drug hypersensitivity coexist. A 31\u2010year\u2010old woman presented with high\u2010spiking fever, arthralgia, and a generalized eruption after ampicillin exposure. Initial investigations for infection and autoimmune disease were unrevealing. Her clinical course was subsequently complicated by severe nosocomial infection and recurrent eruptions during antibiotic treatment. Recurrent high\u2010spiking fever and a fever\u2010associated eruption after apparent clinical improvement of infection supported AOSD as the working diagnosis. However, uncertainty regarding the rash and overlapping infectious and drug\u2010related features limited confident retrospective confirmation of the Yamaguchi classification criteria. Following infection control, intravenous methylprednisolone pulse therapy followed by cyclosporine resulted in rapid clinical improvement. This case illustrates the diagnostic complexity of AOSD in the setting of nosocomial infection and antibiotic hypersensitivity.<\/jats:p>","DOI":"10.1155\/crii\/4891053","type":"journal-article","created":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T09:53:30Z","timestamp":1792230810000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Complexity of Adult\u2010Onset Still\u2019s Disease in the Setting of Nosocomial Infection and Antibiotic Hypersensitivity"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1071-1661","authenticated-orcid":false,"given":"Mei-Chun","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Pharmacy MacKay Memorial Hospital  Taipei Taiwan  mmh.org.tw"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao-Hsien","family":"Lee","sequence":"additional","affiliation":[{"name":"Critical Care Division Internal Medicine Department MacKay Memorial Hospital  Taipei Taiwan  mmh.org.tw"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9942-1814","authenticated-orcid":false,"given":"Tzu-Han","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Dermatology MacKay Memorial Hospital  Taipei Taiwan  mmh.org.tw"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya-Hui","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy MacKay Memorial Hospital  Taipei Taiwan  mmh.org.tw"},{"name":"School of Medicine College of Medicine MacKay Medical University  New Taipei City Taiwan  mmu.edu.tw"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,17]]},"reference":[{"key":"e_1_2_6_1_2","first-page":"424","article-title":"Preliminary Criteria for Classification of Adult Still\u2019s Disease","volume":"19","author":"Yamaguchi M.","year":"1992","journal-title":"Journal of Rheumatology"},{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2021.06.004"},{"key":"e_1_2_6_3_2","first-page":"212","article-title":"Extremely High Serum Ferritin Levels as Diagnostic Tool in Adult-Onset Still\u2019s Disease","volume":"65","author":"Meijvis S. 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