{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T15:31:57Z","timestamp":1784043117466,"version":"3.55.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T00:00:00Z","timestamp":1711584000000},"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>Allergic reactions to drugs caused by piperacillin-tazobactam are common in clinical practice. However, we also found a few cases of drug-induced hypersensitivity syndrome (DiHS)\/Drug reaction with eosinophilia and systemic symptoms (DRESS) caused by piperacillin-tazobactam in our clinical work. We report a case of a 60-year-old female patient who was treated with piperacillin-tazobactam anti-infective therapy after the diagnosis of hematogenous lung abscess, developed fever, rash, and blood abnormalities after 26\u2009days of application, and was later diagnosed as DIHS, which was improved after the administration of glucocorticoid and anti-allergic drugs. In addition, we also retrospectively analyzed 17 cases of DiHS caused by piperacillin-tazobactam from the PubMed databases between March 1980 and September 2023. The majority of the patients had an incubation period of more than 14\u2009days, and the common clinical features included elevated eosinophil count\/percentage, fever, rash, liver damage, and lymph node enlargement. After treatment with topical or systemic glucocorticoids, 16 of the 17 patients improved and one died because of the underlying condition. The clinical features of DiHS were diverse and included a long incubation period, skin rash, elevated eosinophils, and impaired organ function. Since some patients have atypical clinical features, clinicians should raise awareness of the disease, recognize these features early, and treat them promptly.<\/jats:p>","DOI":"10.3389\/fmed.2024.1338247","type":"journal-article","created":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T04:38:39Z","timestamp":1711600719000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Drug-induced hypersensitivity syndrome related to piperacillin-tazobactam: a case report and review of the literature"],"prefix":"10.3389","volume":"11","author":[{"given":"Ya","family":"Shen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun-shun","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-bao","family":"Teng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming-feng","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,3,28]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"295","DOI":"10.2165\/00002018-200730040-00002","article-title":"Systematic review of piperacillin-induced neutropenia","volume":"30","author":"Scheetz","year":"2007","journal-title":"Drug Saf"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1186\/s13052-018-0535-4","article-title":"Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome in two young children: the importance of an early diagnosis","volume":"44","author":"Castellazzi","year":"2018","journal-title":"Ital J Pediatr"},{"key":"ref3","first-page":"433","article-title":"Use of the lymphocyte transformation test in the diagnosis of DRESS syndrome induced by ceftriaxone and piperacillin-tazobactam: two case reports","volume":"20","author":"Jurado-Palomo","year":"2010","journal-title":"J Investig Allergol Clin Immunol"},{"key":"ref4","first-page":"425","article-title":"Piperacillin-induced DRESS: distinguishing features observed in a clinical and allergy study of 8 patients","volume":"24","author":"Cabanas","year":"2014","journal-title":"J Investig Allergol Clin Immunol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"98","DOI":"10.5021\/ad.2016.28.1.98","article-title":"Piperacillin\/Tazobactam-associated hypersensitivity syndrome with overlapping features of acute generalized Exanthematous Pustulosis and drug-related rash with eosinophilia and systemic symptoms syndrome","volume":"28","author":"Kim","year":"2016","journal-title":"Ann Dermatol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1016\/j.jaip.2016.10.008","article-title":"HLA B62 as a possible risk factor for drug reaction with eosinophilia and systemic symptoms to piperacillin\/tazobactam","volume":"5","author":"Rutkowski","year":"2017","journal-title":"J Allergy Clin Immunol Pract"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1007\/s13671-021-00348-z","article-title":"Updates and insights in the diagnosis and management of DRESS syndrome","volume":"10","author":"Schunkert","year":"2021","journal-title":"Curr Dermatol Rep"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"897","DOI":"10.1056\/NEJM195006082422304","article-title":"Dilantin sensitivity; report of a case of hepatitis with jaundice, pyrexia and exfoliative dermatitis","volume":"242","author":"Chaiken","year":"1950","journal-title":"N Engl J Med"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2878","DOI":"10.1016\/j.jaip.2020.07.005","article-title":"Delabeling delayed drug hypersensitivity: how far can you safely go?","volume":"8","author":"Lehloenya","year":"2020","journal-title":"J Allergy Clin Immunol Pract"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.1016\/j.jaip.2022.02.004","article-title":"Drug-induced hypersensitivity syndrome (DIHS)\/drug reaction with eosinophilia and systemic symptoms (DRESS): clinical features and pathogenesis","volume":"10","author":"Hama","year":"2022","journal-title":"J Allergy Clin Immunol Pract"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1108","DOI":"10.1001\/archderm.134.9.1108","article-title":"Human herpesvirus 6 infection as a risk factor for the development of severe drug-induced hypersensitivity syndrome","volume":"134","author":"Suzuki","year":"1998","journal-title":"Arch Dermatol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.2332\/allergolint.55.1","article-title":"Drug-induced hypersensitivity syndrome (DIHS): a reaction induced by a complex interplay among herpesviruses and antiviral and antidrug immune responses","volume":"55","author":"Shiohara","year":"2006","journal-title":"Allergol Int"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"216","DOI":"10.4168\/aair.2014.6.3.216","article-title":"Comparison of diagnostic criteria and determination of prognostic factors for drug reaction with eosinophilia and systemic symptoms syndrome","volume":"6","author":"Kim","year":"2014","journal-title":"Allergy, Asthma Immunol Res"},{"key":"ref14","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":"ref15","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1111\/j.1398-9995.1998.tb03986.x","article-title":"Hypersensitivity to piperacillin","volume":"53","author":"Cabanas","year":"1998","journal-title":"Allergy"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1187937","DOI":"10.3389\/fmed.2023.1187937","article-title":"Advances in understanding of the pathogenesis and therapeutic implications of drug reaction with eosinophilia and systemic symptoms: an updated review","volume":"10","author":"Chen","year":"2023","journal-title":"Front Med"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.3390\/biomedicines11010177","article-title":"Delayed drug hypersensitivity reactions: molecular recognition, genetic susceptibility, and immune mediators","volume":"11","author":"Chu","year":"2023","journal-title":"Biomedicine"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"e229","DOI":"10.1016\/j.jaad.2010.11.057","article-title":"A review of DRESS-associated myocarditis","volume":"66","author":"Bourgeois","year":"2012","journal-title":"J Am Acad Dermatol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"943","DOI":"10.4103\/0366-6999.204104","article-title":"Drug reaction with eosinophilia and systemic symptoms: retrospective analysis of 104 cases over one decade","volume":"130","author":"Wang","year":"2017","journal-title":"Chin Med J"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"1140339","DOI":"10.3389\/fmed.2023.1140339","article-title":"Case report: sulfasalazine-induced hypersensitivity","volume":"10","author":"Kuchinskaya","year":"2023","journal-title":"Front Med"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"670","DOI":"10.1016\/j.jaad.2018.08.052","article-title":"Drug-induced hypersensitivity syndrome\/drug reaction with eosinophilia and systemic symptoms severity score: a useful tool for assessing disease severity and predicting fatal cytomegalovirus disease","volume":"80","author":"Mizukawa","year":"2019","journal-title":"J Am Acad Dermatol"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"e242240","DOI":"10.1136\/bcr-2021-242240","article-title":"Successful mepolizumab treatment for DRESS-induced refractory eosinophilic myocarditis and concurrent thyroiditis","volume":"14","author":"Truong","year":"2021","journal-title":"BMJ Case Rep"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1338247\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,28]],"date-time":"2024-03-28T04:38:44Z","timestamp":1711600724000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2024.1338247\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,28]]},"references-count":22,"alternative-id":["10.3389\/fmed.2024.1338247"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2024.1338247","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,28]]},"article-number":"1338247"}}