Reactions 1704, p110 - 2 Jun 2018 Various toxicities: case report A 71-year-old man developed septic shock, respiratory failure, acute kidney injury, gastrointestinal ulcers and gastrointestinal bleeding secondary to acute generalised exanthematous pustulosis (AGEP) during treatment with rd clindamycin for cellulitis of the left 3 digit. The man had a remarkable history of atrial fibrillation, non- insulin-dependent diabetes mellitus (NIDDM), chronic kidney disease (CKD) and bilateral below knee amputation (BKA). He also had a history of mild AGEP with piperacillin/tazobactam [Zosyn]. He started receiving treatment with clindamycin rd [route and dosage not stated] for cellulitis of his left 3 digit. Forty eight hours after the start of clindamycin, he developed an intense morbilliform rash, which was suspect to be due to Therefore, the man’s treatment with clindamycin was discontinued. On day 3, he developed diarrhoea, fever, dyspnoea, hypotension and rash with pustules. He was then transferred to the emergency room and admitted to the medical ICU following a diagnosis of septic shock. He also developed leucocytosis. The chest, abdomen and pelvic CT showed reactive lymphadenopathy. His hospital course was complicated by respiratory failure, which required intubation. He developed acute kidney injury, which required continuous renal replacement therapy. He also developed gastrointestinal bleeding due to multiple gastrointestinal ulcers. Eventually, he was diagnosed with septic shock due to AGEP. He received treatment with triamcinolone and methylprednisolone sodium succinate, which led to normalisation of the laboratory values. Over a 3 week period, his clinical condition improved. Author comment: "We describe a patient with AGEP with shock and multi-organ involvement due to Clindamycin." Yerneni RR, et al. Acute generalized exanthematous pustulosis, a rare drug reaction. Journal of the American Geriatrics Society 66 (Suppl. 2): S104 (plus poster) abstr. B31, Jan 2018. Available from: URL: http://doi.org/10.1111/ jgs.15376 [abstract] - USA 803323433 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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