2015
DOI: 10.1186/s40560-015-0114-3
|View full text |Cite
|
Sign up to set email alerts
|

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

Abstract: 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… Show more

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...
3
1
1

Citation Types

0
13
0

Year Published

2017
2017
2024
2024

Publication Types

Select...
9

Relationship

0
9

Authors

Journals

citations
Cited by 17 publications
(13 citation statements)
references
References 11 publications
0
13
0
Order By: Relevance
“…The first suspicion of a SCAR should warrant a skin biopsy to definitively determine the etiology for this SCAR. Establishing the etiology is an important step for a correct diagnosis since clinical symptoms alone are not reliable for SCAR diagnosis [12][13][14]. Treatment of SCARs begins with discontinuation of the suspected offending drug, but further management should be tailored to the specific reaction with prompt diagnosis.…”
Section: Discussionmentioning
confidence: 99%
“…The first suspicion of a SCAR should warrant a skin biopsy to definitively determine the etiology for this SCAR. Establishing the etiology is an important step for a correct diagnosis since clinical symptoms alone are not reliable for SCAR diagnosis [12][13][14]. Treatment of SCARs begins with discontinuation of the suspected offending drug, but further management should be tailored to the specific reaction with prompt diagnosis.…”
Section: Discussionmentioning
confidence: 99%
“…5 However, only 15 adult cases of AGEP with haemodynamic instability have been reported in the literature. [9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] The pathophysiology of AGEP is a drug-specific CD4+ and CD8+ T cell response that results in increased production of IL-8, a potent neutrophilattracting chemokine. 25 Other inflammatory cytokines, including IL-17 and IL-22, also have a role in the pathophysiology of AGEP, and may be involved in the systemic complications of AGEP.…”
Section: Discussionmentioning
confidence: 99%
“…However, to the best of our knowledge, there have been only a few reported cases of AGEP with such severe presentation and none of these cases were associated with the use of erythromycin and fluconazole. 7 8 In most of the severe presentations, vancomycin was the culprit medication. 7 8 It is possible that the combined effect of erythromycin and fluconazole which are both hepatically metabolised and alter each other's metabolism leading to increased drug levels resulted in the drug reaction being severe with systemic involvement as an affect.…”
Section: Discussionmentioning
confidence: 99%