{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T11:32:12Z","timestamp":1788089532425,"version":"build-2803163510"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 44-year-old woman with an infected pilon fracture nonunion developed Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) after prolonged intravenous vancomycin and implantation of a vancomycin\/tobramycin-loaded antibiotic cement spacer (ACS). Fevers, rash, and eosinophilia persisted despite stopping systemic vancomycin and starting corticosteroids. ACS explantation led to symptom resolution; however, severe thrombocytopenia developed, requiring therapeutic plasma exchange. A daptomycin-loaded spacer was reimplanted before definitive hindfoot fusion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This case of DRESS in the setting of an ACS highlights management challenges, supports early recognition and spacer removal, proposes a treatment algorithm, and suggests daptomycin as an alternative for local antibiotic delivery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.25.00470","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T19:00:31Z","timestamp":1769194831000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Drug Reaction with Eosinophilia and Systemic Symptoms Following Antibiotic Cement Spacer Placement"],"prefix":"10.2106","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4851-5559","authenticated-orcid":false,"given":"Jonathan C.","family":"Arnold","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elliot","family":"Druten","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2632-1060","authenticated-orcid":false,"given":"Rachel","family":"Kowal","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6421-9736","authenticated-orcid":false,"given":"Jan","family":"Szatkowski","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4735-2818","authenticated-orcid":false,"given":"Luke A.","family":"Lopas","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,1]]},"reference":[{"issue":"5","key":"bib1-20260123","doi-asserted-by":"crossref","first-page":"885","DOI":"10.1016\/j.jaad.2023.02.072","article-title":"Drug-induced hypersensitivity syndrome\/drug reaction with eosinophilia and systemic symptoms. 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