J Korean Med Sci.  2011 Feb;26(2):301-303. 10.3346/jkms.2011.26.2.301.

Drug Fever Due to Piperacillin/Tazobactam Loaded into Bone Cement

• Park HB
• Choi JS
• Park SH
• Kee WJ
• Koh YI

• KMID: 1782123
• DOI: http://doi.org/10.3346/jkms.2011.26.2.301

Abstract

Although drug fever may develop after administration of the drug by various routes, it has not been reported with antibiotic-loaded bone cement. Here, a case of drug fever induced by piperacillin/tazobactam loaded into bone cement is reported. A 72-yr-old woman presented with fever that developed two weeks after insertion of bone cement loaded with antibiotics including piperacillin/tazobactam into the knee joint for infectious arthritis. The fever was associated with a skin rash and blood eosinophilia. The work-up of the fever excluded several causes. Drug provocation test demonstrated that the piperacillin/tazobactam, which had been loaded in the bone cement, was the cause of the fever. The findings of this case suggest that drug fever can be induced by any drug placed and released continuously within the body. Therefore, the evaluation for possible drug fever should include all drugs the patient has been exposed to regardless of the route of administration.

Keyword

Bone Cements; Drug Hypersensitivity; Fever; Piperacillin

MeSH Terms

Aged
Anti-Bacterial Agents/*adverse effects
Arthritis/drug therapy/pathology/surgery
Bone Cements/*adverse effects/*chemistry
Drug Therapy, Combination
Enzyme Inhibitors/adverse effects
Female
Fever/*chemically induced
Humans
Penicillanic Acid/adverse effects/*analogs & derivatives
Piperacillin/*adverse effects

Figure

• 

  Fig. 1 The development of fever, skin rash and blood eosinophilia in relation to the insertion of antibiotic-loaded bone cement and the administration of systemic antibiotics. The bone cement was loaded with piperacillin/tazobactam, ceftezol sodium, gentamicin and vancomycin hydrochloride.

• 

  Fig. 2 Drug provocation test with piperacillin/tazobactam.

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