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Rash associated with piperacillin/tazobactam administration in infectious mononucleosis

Aimée C LeClaire1, Craig A Martin, Ardis D Hoven

  • 1Pharmacy Services, Chandler Medical Center, University of Kentucky, 800 Rose Street, Lexington, KY 40536-0293, USA.

The Annals of Pharmacotherapy
|April 29, 2004
PubMed
Abstract

Insights

This case report details a piperacillin/tazobactam-induced rash in a patient with infectious mononucleosis. The rash resolved after discontinuing the antibiotic, highlighting a potential adverse drug reaction in EBV-positive patients.

Area of Science:

  • Infectious Diseases
  • Pharmacology
  • Dermatology

Background:

  • Infectious mononucleosis, caused by Epstein-Barr virus (EBV), can present with various symptoms.
  • Antibiotic-induced rashes are a known complication of antimicrobial therapy.
  • Piperacillin/tazobactam is a commonly used broad-spectrum antibiotic.

Observation:

  • A 25-year-old male developed a progressive rash while on intravenous piperacillin/tazobactam and gentamicin for osteomyelitis.
  • The rash resolved rapidly upon discontinuation of piperacillin/tazobactam.
  • The patient was subsequently diagnosed with infectious mononucleosis, confirmed by positive EBV serology.

Findings:

  • This is the first reported case of a piperacillin/tazobactam-induced rash in a patient with infectious mononucleosis.
  • The Naranjo probability scale classified the association between piperacillin/tazobactam and the rash as probable.
  • The rash is likely self-limiting and resolves after the causative agent is removed.

Implications:

  • Clinicians should consider piperacillin/tazobactam as a potential cause of rash in patients with infectious mononucleosis, especially in the absence of penicillin allergy.
  • Further investigation into the mechanisms of drug-induced hypersensitivity in EBV-infected individuals may be warranted.
  • This case underscores the importance of careful medication review and adverse event monitoring in clinical practice.

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