Pharmacology Departement, Medicine University, Monastir, Tunisia.
Fundam Clin Pharmacol. 2010 Aug;24(4):429-32. doi: 10.1111/j.1472-8206.2009.00794.x. Epub 2009 Nov 18.
We report a case of acute generalized exanthematous pustulosis (AGEP) after cefotaxime use confirmed by a positive patch test. A 30-year-old woman received cefotaxime, fosfomycin and ciprofloxacin for sinusitis. Twelve days after drug initiation, she developed an extending pustular erythema associated with fever. Laboratory investigations showed marked leukocytosis. His blood chemistry was normal. The histological examination showed parakeratosis, spongiosis and nonfollicular 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 All medications were withdrawn.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 AGEP reaction was caused by cefotaxime. To our knowledge, this is the first reported case of AGEP associated with positive cefotaxime patch testing.
我们报告了一例头孢噻肟使用后确诊的急性泛发性发疹性脓疱病（AGEP），其阳性斑贴试验结果也证实了这一点。一名 30 岁女性因鼻窦炎接受头孢噻肟、磷霉素和环丙沙星治疗。用药 12 天后，她出现了扩展的脓疱性红斑，并伴有发热。实验室检查显示白细胞显著增多。血液化学检查正常。组织学检查显示角化不全、海绵形成和非滤泡性表皮内脓疱，符合 AGEP 的特征。所有药物均被停用。头孢噻肟停药后 11 天内症状缓解。头孢噻肟在 48 小时后斑贴试验阳性，而环丙沙星和磷霉素则为阴性。根据 Naranjo 算法，头孢噻肟引起 AGEP 反应的可能性较大。据我们所知，这是首例与头孢噻肟阳性斑贴试验相关的 AGEP 病例报告。
