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Autumn 2018, Vol. 26 No. 3

Hong Kong J. Dermatol. Venereol. (2018) 26, 127-131


Case Report

Acute generalised exanthematous pustulosis, an atypical presentation of severe leptospirosis

急性泛發性發疹性膿皰病,一宗嚴重鉤端螺旋體病的非典型表現

KN How 何糠年, TH Tang 陳天慧, SH Tee 鄭淑芳

Abstract

Background: Acute generalised exanthematous pustulosis (AGEP) is a condition associated with acute onset of fever with numerous non-follicular pin head sterile pustules on an erythematous background, commonly precipitated by drugs. Infections have been occasionally associated with AGEP. Leptospirosis is a zoonotic infection due to Leptospira spp. We are reporting as far as we are aware, the first case of leptospirosis-induced AGEP. A 33-year-old Malay woman presented with acute febrile, generalised pin-point pustular skin eruptions on an oedematous erythematous background, multi-organ dysfunction and haemodynamic instability. She recovered well with penicillin-group of antibiotics, skin care and supportive management. Leptospira DNA RT-PCR test was positive.

急性泛發性發疹性膿皰病是一種伴隨急性發熱的皮疹,在紅斑上有著許多針頭大小非濾泡的無菌膿皰,多數是由藥物引起,偶爾可以是感染相關的。鉤端螺旋體病是由鉤端螺旋體屬引起的人畜共通傳染病。現報告我們所知的第一例鉤端螺旋體病引起的急性泛發性發疹性膿皰病。一名33歲的馬來女性患有急性發熱,並全身發出伴有水腫和紅斑背景的針頭大小膿皰性皮疹,另有多重器官衰竭和血行動力循環不足。她的病情在獲處方青黴素類抗生素,皮膚護理和支持性治療後恢復良好。鉤端螺旋體的脫氧核醣核酸轉錄聚合酶連鎖反應測試呈陽性。

Keywords: Acute generalised exanthematous pustulosis, Febrile rash, Infection, Leptospirosis, Severe cutaneous adverse drug reaction

關鍵詞: 急性泛發性發疹性膿皰病、發熱性皮疹、感染、鉤端螺旋體病、嚴重皮膚藥物不良反應