PMC9577609_01
Computed tomography (CT) on admission showing chronic bronchitis with bilateral lung infection (A); CT presentation on day 14 of hospitalization (day 3 of meropenem administration): No obvious lesions in both lungs. However, multiple enlarged lymph nodes are seen in the mediastinum and bilateral axillae (B).
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F1
Computed tomography (CT) of the chest revealed chronic bronchitis with bilateral lung infections (Figure 1). Although a chest CT scan showed no obvious lung lesions (Figure 1), it revealed multiple enlarged lymph nodes in the mediastinum and bilateral axillae.
On days 10-12 of Pip/taz, the patient develops hyperthermia with persistently elevated PCT but normal eosinophils. After discontinuing Pip/taz and administering meropenem for 72 h (Day 15), the patient develops the characteristics of DRESS reaction (generalized rash, elevated eosinophils, hematologic abnormalities, and organ involvement), along with a markedly elevated PCT. After stopping the sensitizing drug and giving corticosteroids and anti-allergic drugs for about 1 week, the DRESS reaction subsides, and PCT decreases.
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F2
Serum PCT was persistently elevated (Figure 2). These results also showed persistently elevated eosinophils,1.69 x 109/L (Figure 2); B-type natriuretic peptide (BNP), 1,575 pg/mL; IL-6, 9.45 pg/ml; IL-10, 26.51 pg/ml; and interferon-gamma (IFN-gamma), 116.17 pg/ml.