Meropenem Induced Skin Drug Eruption in Infectious Mononucleosis: Immunological Phenomena or Non-immunological Phenomena?

Abstract

0-year-old woman with fever (39 °C) and chill was referred to our emergency department. She had noticeable jaundice and scleral icterus. She also reported a two-day history of epigastric pain radiating to the right upper quadrant, a mild sore throat, and urine discoloration. In the primary laboratory findings, elevated liver enzymes were detected, and abdominal sonography showed splenomegaly (131 mm) and gallbladder wall thickening (9 mm). Based on the clinical, laboratory, and imaging findings, the diagnosis of acalculous cholecystitis was made. For further evaluation, a complete serology test for viral and autoimmune hepatitis was required, which were all negative. Subsequently, the detection of immunoglobulin m (Igm) viral capsid antigen (vCa) epstein-Barr virus (eBv) antibody and Igm cytomegalovirus (Cmv) antibody was required. Based on the fever and abdominal pain, meropenem at a dose of 1 g three-times-daily was administered to the patient until the result of the laboratory test report. after one day, a generalized maculopapular rash developed on her face and spread to all parts of the body.