{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T18:34:12Z","timestamp":1770834852563,"version":"3.50.1"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T00:00:00Z","timestamp":1664841600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>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.<\/jats:p>","DOI":"10.3389\/fmed.2022.951714","type":"journal-article","created":{"date-parts":[[2022,10,4]],"date-time":"2022-10-04T10:20:00Z","timestamp":1664878800000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Drug-induced hypersensitivity syndrome with high procalcitonin levels due to piperacillin\/tazobactam and meropenem: A case report"],"prefix":"10.3389","volume":"9","author":[{"given":"Gao","family":"Song","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meng-Qun","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rong","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cai-Qiong","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ping","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,10,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1016\/B978-0-7020-6896-6.00048-X","article-title":"Drug hypersensitivity","volume":"53","author":"Castells","year":"2019","journal-title":"Clin Immunol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"179","DOI":"10.3389\/fmed.2017.00179","article-title":"New insights into drug reaction with eosinophilia and systemic symptoms pathophysiology","volume":"4","author":"Musette","year":"2017","journal-title":"Front Med."},{"key":"B3","doi-asserted-by":"publisher","first-page":"1323","DOI":"10.1016\/j.jaad.2020.03.081","article-title":"Drug reaction with eosinophilia and systemic symptoms (DRESS) in the pediatric population: a systematic review of the literature","volume":"83","author":"Kim","year":"2020","journal-title":"J Am Acad Dermatol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"165","DOI":"10.2500\/aap.2012.33.3498","article-title":"The importance of vancomycin in drug rash with eosinophilia and systemic symptoms (DRESS) syndrome","volume":"33","author":"Blumenthal","year":"2012","journal-title":"Allergy Asthma Proc."},{"key":"B5","unstructured":"Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome identified in the electronic health record allergy module63340\n            WolfsonAR\n            ZhouL\n            LiY\n            PhadkeNA\n            ChowOA\n            BlumenthalKG\n          10.1016\/j.jaip.2018.08.01330176295J Allergy Clin Immunol Pract.72019"},{"key":"B6","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1016\/j.anai.2019.06.017","article-title":"Procalcitonin as a diagnostic marker for differentiating DRESS syndrome from bacterial infection","volume":"123","author":"Rhyou","year":"2019","journal-title":"Ann Allergy Asthma Immunol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"P94","DOI":"10.1186\/2045-7022-4-S3-P94","article-title":"DRESS is a cause of increased serum procalcitonin level without bacterial infection","volume":"4","author":"Said","year":"2014","journal-title":"Clin Transl Allergy."},{"key":"B8","doi-asserted-by":"publisher","first-page":"218","DOI":"10.11604\/pamj.2017.28.218.10828","article-title":"Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome associated with cefotaxime and clindamycin use in a 6 year-old boy: a case report","volume":"28","author":"Karakayali","year":"2017","journal-title":"Pan Afr Med J."},{"key":"B9","doi-asserted-by":"publisher","first-page":"e054346","DOI":"10.1136\/bmjopen-2021-054346","article-title":"Impact of '4+7' volume-based drug procurement on the use of policy-related original and generic drugs: a natural experimental study in China","volume":"12","author":"Wang","year":"2022","journal-title":"BMJ Open."},{"key":"B10","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1111\/j.1365-2133.2006.07704.x","article-title":"Variability in the clinical pattern of cutaneous side-effects of drugs with systemic symptoms: does a DRESS syndrome really exist?","volume":"156","author":"Kardaun","year":"2007","journal-title":"Br J Dermatol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"332","DOI":"10.1186\/1752-1947-8-332","article-title":"Drug reaction with eosinophilia and systemic symptoms syndrome (DRESS) syndrome associated with azithromycin presenting like septic shock: a case report","volume":"8","author":"Sriratanaviriyakul","year":"2014","journal-title":"J Med Case Rep."},{"key":"B12","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1016\/j.jaad.2013.01.033","article-title":"DRESS syndrome: part I. 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