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A case of recurrent acute generalized exanthematous pustulosis due to beta-lactam antibiotics: a case report

V Mysore1, A Ghuloom

  • 1Salmaniya Hospital, PB 12, Manama, Bahrain. venkatm@batelco.com.bh

The Journal of Dermatological Treatment
|May 15, 2003
PubMed

Insights

Acute generalized exanthematous pustulosis (AGEP) recurred in a septicemic patient due to three beta-lactam antibiotics. This is the first report of AGEP from piperacillin, ceftazidime, and meropenem, with spontaneous rash resolution.

Area of Science:

  • Dermatology
  • Pharmacology
  • Infectious Diseases

Background:

  • Acute generalized exanthematous pustulosis (AGEP) is a severe cutaneous adverse drug reaction.
  • Beta-lactam antibiotics are common triggers for various drug reactions.
  • Septicemic patients often require broad-spectrum antibiotic treatment.

Observation:

  • A patient with sepsis experienced recurrent episodes of AGEP.
  • The recurrent AGEP was triggered by three distinct beta-lactam antibiotics: piperacillin, ceftazidime, and meropenem.
  • Each episode of rash resolved spontaneously without specific intervention.

Findings:

  • This case is the first documented instance of AGEP induced by the combination of piperacillin, ceftazidime, and meropenem.
  • The findings highlight the potential for cross-reactivity or sequential sensitization to different beta-lactam antibiotics.
  • The study demonstrates that AGEP, even when severe, can exhibit spontaneous resolution.

Implications:

  • Clinicians should consider AGEP in septicemic patients presenting with pustular rashes, especially during broad-spectrum antibiotic therapy.
  • Awareness of potential AGEP triggers among beta-lactam antibiotics is crucial for patient safety.
  • Further research is needed to understand the mechanisms of recurrent AGEP and its spontaneous resolution.

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