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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...

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Autores principales: Botelho, L.F.F., Picosse, F.R., Padilha, M.H., Michalany, N., Góis, A., Porro, A.M.
Formato: Texto
Lenguaje:English
Publicado: S. Karger AG 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2988841/
https://www.ncbi.nlm.nih.gov/pubmed/21103192
http://dx.doi.org/10.1159/000314474
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author Botelho, L.F.F.
Picosse, F.R.
Padilha, M.H.
Michalany, N.
Góis, A.
Porro, A.M.
author_facet Botelho, L.F.F.
Picosse, F.R.
Padilha, M.H.
Michalany, N.
Góis, A.
Porro, A.M.
author_sort Botelho, L.F.F.
collection PubMed
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.
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spelling pubmed-29888412010-11-22 Acute Generalized Exanthematous Pustulosis Induced by Cefepime: A Case Report Botelho, L.F.F. Picosse, F.R. Padilha, M.H. Michalany, N. Góis, A. Porro, A.M. Case Rep Dermatol Published: June 2010 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. S. Karger AG 2010-06-01 /pmc/articles/PMC2988841/ /pubmed/21103192 http://dx.doi.org/10.1159/000314474 Text en Copyright © 2010 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial-No-Derivative-Works License (http://creativecommons.org/licenses/by-nc-nd/3.0/). Users may download, print and share this work on the Internet for noncommercial purposes only, provided the original work is properly cited, and a link to the original work on http://www.karger.com and the terms of this license are included in any shared versions.
spellingShingle Published: June 2010
Botelho, L.F.F.
Picosse, F.R.
Padilha, M.H.
Michalany, N.
Góis, A.
Porro, A.M.
Acute Generalized Exanthematous Pustulosis Induced by Cefepime: A Case Report
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 Published: June 2010
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2988841/
https://www.ncbi.nlm.nih.gov/pubmed/21103192
http://dx.doi.org/10.1159/000314474
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