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BMJ Case Reports 2009; doi:10.1136/bcr.06.2008.0343
  • Rare disease

Acute generalised exanthematous pustulosis (AGEP) after cefotaxime use

  1. Amel Chaabane1,
  2. Karim Aouam1,
  3. Khaled Harrathi2,
  4. Najib Ben Yahia3,
  5. Elyes Gassab2,
  6. Leila Njim3,
  7. Naceur A Boughattas1
  1. 1
    Hopital Fattouma Bourguiba, Faculté de Médecine, Pharmacology, Monastir, 5019, Tunisia
  2. 2
    Hopital Fattouma Bourguiba, Oto-Rhino-Laryngology, Monastir, 5019, Tunisia
  3. 3
    Hopital Fattouma Bourguiba, Anatomopathology, Rue avicenne, Monastir, 5019, Tunisia
  1. Amel Chaabane, chaabane_amel{at}yahoo.fr
  • Published 25 May 2009

Summary

A case of acute generalised exanthematous pustulosis (AGEP) after cefotaxime use confirmed by a positive patch test is reported. A 30-year-old woman received cefotaxime, fosfomycin and ciprofloxacin for sinusitis. At 12 days after drug initiation, she developed an extending pustular erythaema associated with fever. Laboratory investigations showed marked leukocytosis. Her blood chemistry was normal. The histological examination showed parakeratosis, spongiosis and non-follicular intra epidermal pustules consistent with AGEP. All medications were withdrawn. The symptoms resolved within 11 days after cefotaxime discontinuation. Patch tests were positive to cefotaxime after 48 h, while ciprofloxacin and fosfomycin yielded negative findings. Based on the Naranjo algorithm, it is probable that the AGEP reaction was due to cefotaxime. To our knowledge, this is the first reported case of AGEP associated to positive cefotaxime patch testing

Footnotes

  • Competing interests: None.

  • Patient consent: Patient/guardian consent was obtained for publication.

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