TITLE:
Acute Generalized Exanthematous Pustulosis during Puerperal Period Induced by Azithromycin: Case Report
AUTHORS:
Janete Vettorazzi, Edimárlei Gonsales Valério, Michele Luz Kayser, Luíza Guazzelli Pezzali, Daniela Vanessa Vettori, Gabriela Francoes Rostirolla
KEYWORDS:
Acute Generalized Exanthematous Pustulosis, Dermatopathy, High-Risk Gestation, Case Report
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.8 No.12,
October
16,
2018
ABSTRACT: 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.