Chaabane Amel, Aouam Karim, Harrathi Khaled, Yahia Najib Ben, Gassab Elyes, Njim Leila, Boughattas Naceur A
Hopital Fattouma Bourguiba, Faculté de Médecine, Pharmacology, Monastir, 5019, Tunisia.
BMJ Case Rep. 2009;2009. doi: 10.1136/bcr.06.2008.0343. Epub 2009 May 25.
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 All medications were withdrawn.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.
报告了1例头孢噻肟使用后经斑贴试验阳性确诊的急性泛发性脓疱病（AGEP）病例。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。用药后12天，她出现了与发热相关的扩展性脓疱性红斑。实验室检查显示白细胞显著增多。她的血液生化指标正常。组织学检查显示角化不全、海绵形成和与AGEP一致的非毛囊性表皮内脓疱。所有药物均停用。停用头孢噻肟后11天内症状缓解。斑贴试验在48小时后对头孢噻肟呈阳性，而环丙沙星和磷霉素结果为阴性。根据Naranjo算法，AGEP反应很可能是由头孢噻肟引起的。据我们所知，这是首例与头孢噻肟斑贴试验阳性相关的AGEP病例报告。
