Acute Generalized Exanthematous Pustulosis during Puerperal Period Induced by Azithromycin: Case Report  

作　　者：Janete Vettorazzi Edimárlei Gonsales Valério Michele Luz Kayser Luíza Guazzelli Pezzali Daniela Vanessa Vettori Gabriela Francoes Rostirolla 

机构地区：[1]Postgraduate Program in Health Sciences: Gynecology and Obstetrics, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil [2]Department of Gynecology and Obstetrics, Faculty of Medicine (FAMED), Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil [3]Service of Gynecology and Obstetrics, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil

出　　处：《Open Journal of Obstetrics and Gynecology》2018年第12期1156-1162,共7页妇产科期刊（英文）

摘　　要：Background: The use of antibiotics, especially beta-lactams and macrolides, may be associated with dermatopathies, such as Acute Generalized Exanthematous Pustulosis (AGEP), which is an uncommon cutaneous adverse reaction. Case: We report a case of AGEP, in a 36-year-old multiparous (G5P3C1A1) woman, with 38 weeks of gestation, admitted to the hospital to induce labor. Due to cephalopelvic disproportion, the cesarean section was indicated. In the postoperative period, the patient evolved with cutaneous rash, accompanied by productive cough and dyspnea. Because it was a fever of obscure origin, the treatment with antibiotics, including azithromycin, was initiated. On subsequent days, she presented pustules on the back, abdomen and extremities. Such reaction was attributed to the use of azithromycin. When the drug was discontinued, the lesions regressed significantly. Conclusion: The clinical picture of AGEP may occur with persistent high fever and therefore could be confused with systemic infections, consequently, being treated with wrong medications capable of aggravating the adverse cutaneous reaction, worsening the course of the disease that could be easily treated by stopping the use of the causative drug. This case shows the importance of including AGEP as a differential diagnosis of dermatopathies in the pregnancy-puerperal cycle, especially in women who are using various medications, including antibiotics.Background: The use of antibiotics, especially beta-lactams and macrolides, may be associated with dermatopathies, such as Acute Generalized Exanthematous Pustulosis (AGEP), which is an uncommon cutaneous adverse reaction. Case: We report a case of AGEP, in a 36-year-old multiparous (G5P3C1A1) woman, with 38 weeks of gestation, admitted to the hospital to induce labor. Due to cephalopelvic disproportion, the cesarean section was indicated. In the postoperative period, the patient evolved with cutaneous rash, accompanied by productive cough and dyspnea. Because it was a fever of obscure origin, the treatment with antibiotics, including azithromycin, was initiated. On subsequent days, she presented pustules on the back, abdomen and extremities. Such reaction was attributed to the use of azithromycin. When the drug was discontinued, the lesions regressed significantly. Conclusion: The clinical picture of AGEP may occur with persistent high fever and therefore could be confused with systemic infections, consequently, being treated with wrong medications capable of aggravating the adverse cutaneous reaction, worsening the course of the disease that could be easily treated by stopping the use of the causative drug. This case shows the importance of including AGEP as a differential diagnosis of dermatopathies in the pregnancy-puerperal cycle, especially in women who are using various medications, including antibiotics.

关 键 词：ACUTE Generalized Exanthematous PUSTULOSIS Dermatopathy HIGH-RISK GESTATION Case Report 

分 类 号：R73[医药卫生—肿瘤]