Acute Generalized Exanthematous Pustulosis Mimicking Toxic Shock Syndrome in a Pediatric Patient

Acute generalized exanthematous pustulosis (AGEP) is a rare, drug-induced hypersensitivity reaction that can mimic other serious febrile exanthems when pustule formation is delayed. We present a 16-year-old male who developed fever, diffuse erythema, and hypotension after amoxicillin exposure, initially raising concern for toxic shock syndrome. Classic pustules emerged several days into hospitalization, leading to a diagnosis of AGEP supported by clinical scoring. This case highlights the diagnostic challenges of AGEP in its early stages and underscores the importance of considering it in the differential for febrile rashes, particularly after recent beta-lactam antibiotic use.