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Piperacillin-Tazobactam-Induced Generalized Exanthematous Pustulosis

Sudeep Chapagain1, Prabina Basnet1, Surendra Khanal1

  • 1Internal Medicine, Piedmont Athens Regional Medical Center, Athens, USA.

Cureus
|June 10, 2025
PubMed

Insights

Acute generalized exanthematous pustulosis (AGEP), a rare antibiotic reaction, presents with pustules and erythema. This case highlights piperacillin-tazobactam as a trigger, with symptoms resolving after drug cessation.

Area of Science:

  • Dermatology
  • Pharmacology

Background:

  • Acute generalized exanthematous pustulosis (AGEP) is a rare, severe cutaneous adverse reaction.
  • Antibiotics, particularly beta-lactams, are the most common causative agents.
  • AGEP is characterized by widespread sterile pustules on an erythematous background.

Observation:

  • A 58-year-old female developed AGEP following piperacillin-tazobactam administration.
  • Clinical presentation included rapid onset of sterile pustules, swelling, and erythema.
  • Histopathology confirmed neutrophilic pustules and eosinophilic infiltration.

Findings:

  • Piperacillin-tazobactam was identified as the likely trigger for AGEP.
  • Discontinuation of the antibiotic led to symptom resolution.
  • Skin lesions resolved via desquamation within three days of drug cessation.

Implications:

  • This case underscores the importance of recognizing AGEP in patients exposed to piperacillin-tazobactam.
  • Prompt diagnosis and withdrawal of the offending agent are crucial for managing AGEP.
  • Understanding drug-induced AGEP aids in preventing severe cutaneous reactions.
Keywords:
acute generalized exanthematous pustulosisbeta-lactambeta-lactam antibioticscutaneous drug reactionfeverpiperacillin-tazobactam

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