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Vancomycin-induced acute generalized exanthematous pustulosis (AGEP) masquerading septic shock—an unusual presentation of a rare disease

Acute generalized exanthematous pustulosis (AGEP) is a rare cutaneous adverse reaction characterized by acute sterile pustular eruptions, mostly induced by medications. Antibiotics are the most commonly implicated drugs; however, there have only been two previous reports of vancomycin-induced AGEP i...

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Autores principales: Mawri, Sagger, Jain, Tarun, Shah, Jainil, Hurst, Gina, Swiderek, Jennifer
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4641343/
https://www.ncbi.nlm.nih.gov/pubmed/26561525
http://dx.doi.org/10.1186/s40560-015-0114-3
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author Mawri, Sagger
Jain, Tarun
Shah, Jainil
Hurst, Gina
Swiderek, Jennifer
author_facet Mawri, Sagger
Jain, Tarun
Shah, Jainil
Hurst, Gina
Swiderek, Jennifer
author_sort Mawri, Sagger
collection PubMed
description Acute generalized exanthematous pustulosis (AGEP) is a rare cutaneous adverse reaction characterized by acute sterile pustular eruptions, mostly induced by medications. Antibiotics are the most commonly implicated drugs; however, there have only been two previous reports of vancomycin-induced AGEP in the literature. In this case, we present the clinical course of a 56-year-old man who was admitted to the intensive care unit with an unusually severe form of AGEP mimicking septic shock, which developed after the recent use of vancomycin. Despite cessation of the offending agent, our patient continued to clinically decline with development of worsening skin eruptions and hemodynamic instability necessitating vasopressor support. The patient promptly responded to systemic steroid therapy with complete resolution of AGEP. In addition to highlighting the implication of vancomycin in AGEP, we herein discuss the clinical presentation, diagnosis, and management of AGEP, particularly in severe cases admitted to the intensive care unit.
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spelling pubmed-46413432015-11-12 Vancomycin-induced acute generalized exanthematous pustulosis (AGEP) masquerading septic shock—an unusual presentation of a rare disease Mawri, Sagger Jain, Tarun Shah, Jainil Hurst, Gina Swiderek, Jennifer J Intensive Care Case Report Acute generalized exanthematous pustulosis (AGEP) is a rare cutaneous adverse reaction characterized by acute sterile pustular eruptions, mostly induced by medications. Antibiotics are the most commonly implicated drugs; however, there have only been two previous reports of vancomycin-induced AGEP in the literature. In this case, we present the clinical course of a 56-year-old man who was admitted to the intensive care unit with an unusually severe form of AGEP mimicking septic shock, which developed after the recent use of vancomycin. Despite cessation of the offending agent, our patient continued to clinically decline with development of worsening skin eruptions and hemodynamic instability necessitating vasopressor support. The patient promptly responded to systemic steroid therapy with complete resolution of AGEP. In addition to highlighting the implication of vancomycin in AGEP, we herein discuss the clinical presentation, diagnosis, and management of AGEP, particularly in severe cases admitted to the intensive care unit. BioMed Central 2015-11-10 /pmc/articles/PMC4641343/ /pubmed/26561525 http://dx.doi.org/10.1186/s40560-015-0114-3 Text en © Mawri et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Mawri, Sagger
Jain, Tarun
Shah, Jainil
Hurst, Gina
Swiderek, Jennifer
Vancomycin-induced acute generalized exanthematous pustulosis (AGEP) masquerading septic shock—an unusual presentation of a rare disease
title Vancomycin-induced acute generalized exanthematous pustulosis (AGEP) masquerading septic shock—an unusual presentation of a rare disease
title_full Vancomycin-induced acute generalized exanthematous pustulosis (AGEP) masquerading septic shock—an unusual presentation of a rare disease
title_fullStr Vancomycin-induced acute generalized exanthematous pustulosis (AGEP) masquerading septic shock—an unusual presentation of a rare disease
title_full_unstemmed Vancomycin-induced acute generalized exanthematous pustulosis (AGEP) masquerading septic shock—an unusual presentation of a rare disease
title_short Vancomycin-induced acute generalized exanthematous pustulosis (AGEP) masquerading septic shock—an unusual presentation of a rare disease
title_sort vancomycin-induced acute generalized exanthematous pustulosis (agep) masquerading septic shock—an unusual presentation of a rare disease
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4641343/
https://www.ncbi.nlm.nih.gov/pubmed/26561525
http://dx.doi.org/10.1186/s40560-015-0114-3
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