RT Journal Article
SR Electronic
T1 Acute generalised exanthematous pustulosis associated with shock
JF BMJ Case Reports
JO BMJ Case Reports
FD BMJ Publishing Group Ltd
SP e235846
DO 10.1136/bcr-2020-235846
VO 13
IS 10
A1 Philippos Apolinario Costa
A1 Bruna Menon Loureiro Apolinario Costa
A1 Clara Milikowski
A1 Joan E St Onge
YR 2020
UL http://casereports.bmj.com/content/13/10/e235846.abstract
AB A 23-year-old man with a history of end-stage renal disease was admitted to the hospital due to fever and shock, which occurred during his dialysis. One week prior, he developed an erythematous rash on his chest, face and back, associated with generalised eruption of pustules. In hospital, his status did not improve with norepinephrine and empirical broad-spectrum antibiotics. Following this, methylprednisolone was administered with remarkable improvement. Cultures revealed no infectious aetiology. Based on the morphology of the rash and a compatible skin biopsy, the diagnosis of acute generalised exanthematous pustulosis (AGEP) was established and considered the cause of his shock. The causative agent of his AGEP remained unknown. AGEP is a rare condition, most frequently associated with drug exposure. The removal of the offending agent is the treatment of choice. It can be complicated by shock in rare cases. In that scenario, systemic corticosteroids seem to improve outcomes greatly.