{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:20:54Z","timestamp":1760059254102,"version":"build-2065373602"},"reference-count":15,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: Prevention of an irreversible sequalae in neurosyphilis patients requires immediate high-dose intravenous benzylpenicillin administered for a prolonged period of time. However, life-threatening neutropenia has been reported as one of the complications following extended usage of benzylpenicillin. Case presentation: We report a 54-year-old male patient with HIV who developed high-dose benzylpenicillin-induced febrile neutropenia during neurosyphilis treatment. The patient developed a fever of up to 39.8 \u00b0C, severe leukopenia (&lt;1 \u00d7 109\/L), and neutropenia (0.2 \u00d7 109\/L). He also presented with slightly elevated C-reactive protein and procalcitonin levels but had no clear symptoms of other infections. The diagnosis was confirmed by excluding other possible causes of neutropenia: flu, measles, sepsis, and HIV-related neutropenia. Third-generation antipseudomonal cephalosporin in combination with vancomycin and granulocyte colony-stimulating factor were administered, and the patient saw a rapid improvement in clinical symptoms and laboratory findings. Conclusions: High-dose benzylpenicillin-induced neutropenia should be considered a complication after prolonged periods of neurosyphilis treatment with high-dose benzylpenicillin when there is no evidence of other potential causes of neutropenia. Early diagnosis and proper treatment are critical in order to prevent this dangerous condition from deteriorating further.<\/jats:p>","DOI":"10.3390\/antibiotics14060560","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T09:22:41Z","timestamp":1748596961000},"page":"560","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["High-Dose Benzylpenicillin Treatment-Induced Febrile Neutropenia in HIV-Infected Male with Neurosyphilis: Case Report"],"prefix":"10.3390","volume":"14","author":[{"given":"Inga","family":"Sabeckyte-Boveiniene","sequence":"first","affiliation":[{"name":"Infectious Diseases Department, Lithuanian University of Health Sciences, 47144 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kotryna","family":"Krupeckaite","sequence":"additional","affiliation":[{"name":"Infectious Diseases Sector, Utena Hospital, 28151 Utena, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Svajune","family":"Petkeviciute","sequence":"additional","affiliation":[{"name":"Infectious Diseases Sector, Utena Hospital, 28151 Utena, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1771-5194","authenticated-orcid":false,"given":"Evelina","family":"Pukenyte","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Lithuanian University of Health Sciences, 47144 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aukse","family":"Mickiene","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Lithuanian University of Health Sciences, 47144 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9114-9537","authenticated-orcid":false,"given":"Danguole","family":"Vaznaisiene","sequence":"additional","affiliation":[{"name":"Infectious Diseases Department, Lithuanian University of Health Sciences, 47144 Kaunas, Lithuania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1093\/jac\/17.2.251","article-title":"Benzylpenicillin-induced neutropenia","volume":"17","author":"Aman","year":"1986","journal-title":"J. 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