Delayed-type hypersensitivity reaction to piperacillin/tazobactam in a patient with an infected total knee replacement.

Author(s): Song EK, Seon JK, Jeong MS

Affiliation(s): Department of Orthopaedic Surgery, Center for Joint Disease, Chonnam National University, Hwasun Hospital, 160 Ilsimri, Hwasun-eup, Hwasun-gun, Jeonnam 519-809, South Korea.

Publication date & source: 2010-11, J Bone Joint Surg Br., 92(11):1596-9.

Publication type: Case Reports

We describe a patient who developed a delayed-type hypersensitivity reaction to piperacillin/tazobactam in the cement beads and a spacer inserted at revision of total replacement of the left knee. We believe that this is the first report of such a problem. Our experience suggests that a delayed-type hypersensitivity reaction should be considered when a mixture of antibiotics such as piperacillin/tazobactam has been used in the bone cement, beads or spacer and the patient develops delayed symptoms of pain or painful paraesthesiae, fever, rash and abnormal laboratory findings in the absence of infection. The diagnosis was made when identical symptoms were induced by a provocation challenge test.