Division of Pulmonary and Critical Care, Geisinger Medical Center, Danville, PA 17822, USA.
Am J Crit Care. 2013 May;22(3):270-3. doi: 10.4037/ajcc2013987.
Acute generalized exanthematous pustulosis is a rare condition characterized by sterile pustules on erythematous and edematous tissue. Mostly drug induced, this condition can also be caused by other factors. Cases due to vancomycin are rare. A 67-year-old woman with cellulitis of the left lower extremity was admitted with marked bilateral lymphedema of the lower extremities and diffuse erythema of the left lower extremity from foot to knee. She was given clindamycin and then vancomycin. On day 5, her condition worsened, with erythema involving the entire back. Although treatment with clindamycin and vancomycin was discontinued, acute generalized exanthematous pustulosis developed. After successful treatment of other complications, the skin condition improved. Because vancomycin is frequently used, clinicians should be aware of the possibility of acute generalized exanthematous pustulosis. Because the pustulosis decreases after withdrawal of the causative drug, being able to diagnose and differentiate the abnormality from other conditions is prudent.
急性泛发性发疹性脓疱病是一种罕见的疾病，其特征为在红斑和水肿组织上出现无菌脓疱。这种情况主要由药物引起，但也可能由其他因素引起。万古霉素引起的病例很少见。一位 67 岁的女性因左下肢蜂窝织炎入院，其下肢双侧淋巴水肿明显，左下肢从足部到膝盖弥漫性红斑。给予克林霉素和万古霉素治疗。第 5 天，她的病情恶化，整个背部出现红斑。尽管停止了克林霉素和万古霉素的治疗，但还是发生了急性泛发性发疹性脓疱病。在成功治疗其他并发症后，皮肤状况得到改善。由于万古霉素经常被使用，临床医生应该意识到急性泛发性发疹性脓疱病的可能性。由于脓疱病在停用致病药物后会减轻，因此能够诊断和区分异常与其他情况是谨慎的。
