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Acute generalized exanthematous pustulosis after ceftriaxone use resembling sepsis

Abdurrahman Kaya1, Sibel Yıldız, Ilker Inanc Balkan

  • 1Department of Infectious Disease, Medical School of Cerrahpasa, Istanbul University, Istanbul, Turkey. dr.abdkaya@hotmail.com

Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy
|September 14, 2011
PubMed

Insights

Acute generalized exanthematous pustulosis, a rare skin reaction often triggered by antibiotics like beta-lactams, can mimic sepsis. Prompt withdrawal of the causative drug, such as ceftriaxone, leads to symptom improvement.

Area of Science:

  • Dermatology
  • Pharmacology
  • Infectious Diseases

Background:

  • Acute generalized exanthematous pustulosis (AGEP) is an uncommon, severe cutaneous adverse reaction.
  • It is characterized by widespread sterile pustules on erythematous skin.
  • Medications, especially antibiotics like beta-lactams, are the most common triggers.

Observation:

  • A case of AGEP mimicking sepsis is presented.
  • The patient developed symptoms after administration of ceftriaxone, a beta-lactam antibiotic.
  • The clinical presentation included multiple pruritic, superficial pustules.

Findings:

  • Ceftriaxone was identified as the causative agent for AGEP.
  • Discontinuation of ceftriaxone resulted in significant clinical improvement.
  • The condition highlights the importance of considering drug reactions in sepsis-like presentations.

Implications:

  • This case underscores the need for increased awareness of AGEP in clinical practice, particularly in infectious disease settings.
  • Early recognition and drug withdrawal are crucial for managing AGEP.
  • Healthcare providers should maintain a high index of suspicion for drug-induced dermatoses presenting as systemic illness.

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