Acute Generalized Exanthematous Pustulosis Induced by Cefepime: A Case Report

Acute generalized exanthematous pustulosis (AGEP) is a rare cutaneous rash characterized by widespread sterile nonfollicular pustules. Cefepime is a fourth generation cephalosporin, used to treat severe infections. A 67-year-old man was admitted with acute gastroenterocolitis. On the seventh day, th...

Full description

Bibliographic Details
Main Authors: L.F.F. Botelho, F.R. Picosse, M.H. Padilha, N. Michalany, A. Góis, A.M. Porro
Format: Article
Language:English
Published: Karger Publishers 2010-06-01
Series:Case Reports in Dermatology
Subjects:
Online Access:http://www.karger.com/Article/FullText/314474
_version_ 1828788730555531264
author L.F.F. Botelho
F.R. Picosse
M.H. Padilha
N. Michalany
A. Góis
A.M. Porro
author_facet L.F.F. Botelho
F.R. Picosse
M.H. Padilha
N. Michalany
A. Góis
A.M. Porro
author_sort L.F.F. Botelho
collection DOAJ
description Acute generalized exanthematous pustulosis (AGEP) is a rare cutaneous rash characterized by widespread sterile nonfollicular pustules. Cefepime is a fourth generation cephalosporin, used to treat severe infections. A 67-year-old man was admitted with acute gastroenterocolitis. On the seventh day, the patient developed a nosocomial pneumonia and cefepime was initiated. On the fourth day of cephalosporin treatment, he presented with a maculopapular, pruritic eruption affecting the face, neck, abdomen and limbs. One day later he developed disseminated pustular lesions and his temperature was 37°C. Laboratory analysis evidenced leukocytosis and skin biopsy showed subcorneal pustule, edema in the papillary dermis, perivascular inflammatory infiltrate consisting of neutrophils, leukocytoclasia and red cell extravasation in the epidermis. Cefepime was suspended and within 4 days the non-follicular pustules cleared following a desquamation. AGEP is a disease attributed to a variety of causes, but in 90% of the cases it is due to an adverse drug reaction. Antibiotics are implicated in 80% of these cases, mostly penicillins and macrolides. There are few cases associated with cephalosporins. It is very important to consider AGEP in cases of acute pustular rashes and drugs should be investigated as causative agents.
first_indexed 2024-12-12T00:59:05Z
format Article
id doaj.art-7d938223f3a84bb397ee219b623db5d3
institution Directory Open Access Journal
issn 1662-6567
language English
last_indexed 2024-12-12T00:59:05Z
publishDate 2010-06-01
publisher Karger Publishers
record_format Article
series Case Reports in Dermatology
spelling doaj.art-7d938223f3a84bb397ee219b623db5d32022-12-22T00:43:47ZengKarger PublishersCase Reports in Dermatology1662-65672010-06-0122828710.1159/000314474314474Acute Generalized Exanthematous Pustulosis Induced by Cefepime: A Case ReportL.F.F. BotelhoF.R. PicosseM.H. PadilhaN. MichalanyA. GóisA.M. PorroAcute generalized exanthematous pustulosis (AGEP) is a rare cutaneous rash characterized by widespread sterile nonfollicular pustules. Cefepime is a fourth generation cephalosporin, used to treat severe infections. A 67-year-old man was admitted with acute gastroenterocolitis. On the seventh day, the patient developed a nosocomial pneumonia and cefepime was initiated. On the fourth day of cephalosporin treatment, he presented with a maculopapular, pruritic eruption affecting the face, neck, abdomen and limbs. One day later he developed disseminated pustular lesions and his temperature was 37°C. Laboratory analysis evidenced leukocytosis and skin biopsy showed subcorneal pustule, edema in the papillary dermis, perivascular inflammatory infiltrate consisting of neutrophils, leukocytoclasia and red cell extravasation in the epidermis. Cefepime was suspended and within 4 days the non-follicular pustules cleared following a desquamation. AGEP is a disease attributed to a variety of causes, but in 90% of the cases it is due to an adverse drug reaction. Antibiotics are implicated in 80% of these cases, mostly penicillins and macrolides. There are few cases associated with cephalosporins. It is very important to consider AGEP in cases of acute pustular rashes and drugs should be investigated as causative agents.http://www.karger.com/Article/FullText/314474Acute generalized exanthematous pustulosisDrug eruptionCefepime
spellingShingle L.F.F. Botelho
F.R. Picosse
M.H. Padilha
N. Michalany
A. Góis
A.M. Porro
Acute Generalized Exanthematous Pustulosis Induced by Cefepime: A Case Report
Case Reports in Dermatology
Acute generalized exanthematous pustulosis
Drug eruption
Cefepime
title Acute Generalized Exanthematous Pustulosis Induced by Cefepime: A Case Report
title_full Acute Generalized Exanthematous Pustulosis Induced by Cefepime: A Case Report
title_fullStr Acute Generalized Exanthematous Pustulosis Induced by Cefepime: A Case Report
title_full_unstemmed Acute Generalized Exanthematous Pustulosis Induced by Cefepime: A Case Report
title_short Acute Generalized Exanthematous Pustulosis Induced by Cefepime: A Case Report
title_sort acute generalized exanthematous pustulosis induced by cefepime a case report
topic Acute generalized exanthematous pustulosis
Drug eruption
Cefepime
url http://www.karger.com/Article/FullText/314474
work_keys_str_mv AT lffbotelho acutegeneralizedexanthematouspustulosisinducedbycefepimeacasereport
AT frpicosse acutegeneralizedexanthematouspustulosisinducedbycefepimeacasereport
AT mhpadilha acutegeneralizedexanthematouspustulosisinducedbycefepimeacasereport
AT nmichalany acutegeneralizedexanthematouspustulosisinducedbycefepimeacasereport
AT agois acutegeneralizedexanthematouspustulosisinducedbycefepimeacasereport
AT amporro acutegeneralizedexanthematouspustulosisinducedbycefepimeacasereport