Acute generalised exanthematous pustulosis in a child

Area of Science:

• Dermatology
• Pediatrics
• Pharmacology

Background:

• Acute generalised exanthematous pustulosis (AGEP) is a rare, severe cutaneous adverse reaction.
• While often linked to antibiotics, AGEP in children is infrequently reported.
• Cefixime, a common antibiotic, can potentially trigger AGEP.

Purpose of the Study:

• To report a rare case of AGEP in a pediatric patient following oral cefixime administration.
• To highlight the clinical presentation, diagnostic findings, and management of AGEP in a child.
• To emphasize the importance of recognizing AGEP as a potential adverse drug reaction in pediatric populations.

Main Methods:

• Case report of a pediatric patient presenting with fever, cough, and cold.
• Clinical observation of rash development, characterized by an erythematous base with sterile pinpoint pustules.
• Laboratory investigations including hemogram, liver, and renal function tests.
• Treatment protocol involving cessation of cefixime, oral corticosteroids, and antihistamines.

Main Results:

• The patient developed a widespread rash with pustules within 24 hours of starting cefixime.
• Laboratory tests showed mild leukocytosis with normal liver and renal functions.
• Clinical improvement was observed within 48 hours of initiating treatment, with rash resolution and desquamation.

Conclusions:

• AGEP is a rare but significant adverse drug reaction that can occur in children.
• Early recognition and prompt management, including drug withdrawal and corticosteroid therapy, are crucial for favorable outcomes.
• This case underscores the need for increased awareness of AGEP in pediatric patients exposed to cefixime or similar medications.