Meropenem-induced drug hypersensitivity syndrome in children: a case report

Published on Jul. 31, 2026Total Views: 59 times Total Downloads: 13 times Download Mobile

Author: LI Wen ¹ LI Gen ¹ JIANG Yongxian ¹ HU Siqi ¹  ZHANG Bo ²

Affiliation: 1.Department of Pharmacy, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu 610041, China 2.Department of Pharmacy, Yibin Second Hospital of Traditional Chinese Medicine, Yibin 644000, Sichuan Province, China

Keywords: Meropenem Drug hypersensitivity syndrome Adverse reactions Pseudomonas aeruginosa Children

DOI: 10.12173/j.issn.1005-0698.202512011

Reference: Li W, Li G, Jiang YX, et al. Meropenem-induced drug hypersensitivity syndrome in children: a case report[J]. Chinese Journal of Pharmacoepidemiology, 2026, 35(7): 836-840. DOI: 10.12173/j.issn.1005-0698.202512011.[Article in Chinese]  Copied

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Abstract

This report describes a case of meropenem-induced hypersensitivity syndrome in a pediatric patient. The patient, a 10-month-old male, had multi-system (skin, respiratory tract, and hematologic) infection caused by Pseudomonas aeruginosa, with clinical manifestations including fever, subcutaneous induration, rash, diarrhea, convulsions, and anuria. After admission, the patient received sequential anti-infective therapy including cefotaxime 0.5 g ivd q8h, meropenem 0.2 g ivd q8h, cefoperazone-sulbactam 0.5 g ivd q8h, and ceftazidime 0.5 g ivd q12h. After relapse and re-administration of meropenem (22 days after the initial treatment), the patient exhibited classic hypersensitivity reaction syndrome features (generalized rash, multi-site lymphadenopathy, fever, hepatic impairment, and leukocytosis), accompanied by reactivation of Epstein-Barr virus. Symptomatic management with hydrocortisone sodium succinate and immunoglobulin was initiated upon discontinuation of meropenem, resulting in clinical improvement. Naranjo's Assessment Scale evaluation indicated a "highly probable association." This case suggests that meropenem may induce drug hypersensitivity reactions with prolonged latency periods in children, necessitating heightened clinical vigilance, early identification, and comprehensive management.

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