Piperacillin-tazobactam caused post-
trauma patient’s postoperative leukopenia,
hypokalemia, and periodic fever: a case report
Dublin Core
Title
Piperacillin-tazobactam caused post-
trauma patient’s postoperative leukopenia,
hypokalemia, and periodic fever: a case report
trauma patient’s postoperative leukopenia,
hypokalemia, and periodic fever: a case report
Subject
Piperacillin-tazobactam, Periodic fever, Leukopenia, Hypokalemia, Post-trauma surgery.
Description
Abstract
Background Piperacillin-tazobactam (PT), a broad-spectrum β-lactam/β-lactamase inhibitor combination, is
clinically used to treat infections caused by Gram-positive and Gram-negative aerobic and anaerobic bacteria.
While gastrointestinal adverse effects, skin reactions, and fever have been previously reported during PT therapy, its
association with periodic fever, leukopenia, and hypokalemia specifically in post-trauma surgical patients has not
been documented.
Case presentation We report the case of a 55-year-old male trauma patient who received PT for 17 days pre-
operatively for suspected infection. He then underwent surgical procedures including rib fracture open reduction and
internal fixation, along with thoracic closed drainage. Post-operatively, on day 2, the patient developed periodic fever,
occurring specifically between 20:00 and 23:00 hours each night, with normal daytime temperatures. Concurrently,
during PT administration, the patient exhibited leukopenia and hypokalemia. Notably, cessation of PT led to an
immediate resolution of the periodic fever, gradual normalization of leukocyte counts, and restoration of potassium
levels. Although PT can cause fever, diagnosis can be challenging in the post-operative setting due to the potential
for confounding factors.
Conclusions This case suggests that in surgical patients presenting with periodic fever, particularly when
accompanied by leukopenia and hypokalemia after exposure to PT, the drug should be considered a potential
causative agent, even if other post-operative complications are being investigated.
Keywords Piperacillin-tazobactam, Periodic fever, Leukopenia, Hypokalemia, Post-trauma surgery.
Background Piperacillin-tazobactam (PT), a broad-spectrum β-lactam/β-lactamase inhibitor combination, is
clinically used to treat infections caused by Gram-positive and Gram-negative aerobic and anaerobic bacteria.
While gastrointestinal adverse effects, skin reactions, and fever have been previously reported during PT therapy, its
association with periodic fever, leukopenia, and hypokalemia specifically in post-trauma surgical patients has not
been documented.
Case presentation We report the case of a 55-year-old male trauma patient who received PT for 17 days pre-
operatively for suspected infection. He then underwent surgical procedures including rib fracture open reduction and
internal fixation, along with thoracic closed drainage. Post-operatively, on day 2, the patient developed periodic fever,
occurring specifically between 20:00 and 23:00 hours each night, with normal daytime temperatures. Concurrently,
during PT administration, the patient exhibited leukopenia and hypokalemia. Notably, cessation of PT led to an
immediate resolution of the periodic fever, gradual normalization of leukocyte counts, and restoration of potassium
levels. Although PT can cause fever, diagnosis can be challenging in the post-operative setting due to the potential
for confounding factors.
Conclusions This case suggests that in surgical patients presenting with periodic fever, particularly when
accompanied by leukopenia and hypokalemia after exposure to PT, the drug should be considered a potential
causative agent, even if other post-operative complications are being investigated.
Keywords Piperacillin-tazobactam, Periodic fever, Leukopenia, Hypokalemia, Post-trauma surgery.
Creator
Hong Luo1,2†, Xu Zhang3†, Fei Zhang1* and Wuxun Peng1*
Source
https://doi.org/10.1186/s12245-025-01096-8
Date
2026
Contributor
peri irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Hong Luo1,2†, Xu Zhang3†, Fei Zhang1* and Wuxun Peng1*, “Piperacillin-tazobactam caused post-
trauma patient’s postoperative leukopenia,
hypokalemia, and periodic fever: a case report,” Repository Horizon University Indonesia, accessed April 27, 2026, https://repository.horizon.ac.id/items/show/12953.
trauma patient’s postoperative leukopenia,
hypokalemia, and periodic fever: a case report,” Repository Horizon University Indonesia, accessed April 27, 2026, https://repository.horizon.ac.id/items/show/12953.