Piperacillin-tazobactam-induced hemophagocytic lymphohistiocytosis in a patient with community-acquired pneumonia: A case report and literature review on diagnostic challenges of elevated procalcitonin.

ABSTRACT:

Rationale

piperacillin-tazobactam, a widely used broad-spectrum antibiotic, carries a risk of severe adverse reactions, including rare but life-threatening hemophagocytic lymphohistiocytosis (HLH). Elevated procalcitonin (PCT), typically indicative of bacterial infection, can mask this diagnosis, leading to delayed recognition and potentially fatal outcomes. This case underscores the diagnostic challenge of drug-induced HLH mimicking infection.

Patient concerns

a 17-year-old female presented with community-acquired pneumonia (CAP) and severe iron deficiency anemia. Initial piperacillin-tazobactam therapy resolved her fever and respiratory symptoms. However, after 6 afebrile days, she developed recurrent high-grade fever (40.3°C), pancytopenia (WBC 1.81 × 109/L, ANC 0.23 × 10

SUBMITTER: Xia X 

PROVIDER: S-EPMC12643755 | biostudies-literature | 2025 Nov

REPOSITORIES: biostudies-literature