Cefepime-Induced Generalized Fixed Drug Eruption With Morbilliform Rash

Area of Science:

• Dermatology
• Pharmacology

Background:

• Fixed drug eruption (FDE) is a specific type of adverse drug reaction characterized by recurrent, localized skin lesions upon re-exposure to an inciting agent.
• FDEs typically manifest as violaceous plaques, often with subsequent hyperpigmentation, and can be triggered by various medications including antibiotics, NSAIDs, and anticonvulsants.

Observation:

• This report details a case of a generalized fixed drug eruption.
• The eruption was a severe, widespread reaction attributed to the antibiotic cefepime.

Findings:

• The generalized fixed drug eruption secondary to cefepime demonstrated characteristic recurrence patterns.
• Resolution was achieved by discontinuing the causative drug, cefepime.
• Supportive treatment with antihistamines and topical corticosteroids aided in the management of the cutaneous reaction.

Implications:

• This case highlights cefepime as a potential trigger for generalized fixed drug eruptions.
• It underscores the importance of prompt drug withdrawal and symptomatic treatment for managing severe FDE.
• Clinicians should consider FDE in the differential diagnosis of widespread drug-induced skin reactions, particularly with antibiotics like cefepime.