A Case of Acute Generalized Exanthematous Pustulosis (AGEP) with Acute Kidney Injury

Abstract

A 71-year-old woman was administered two antibiotics, clindamycin (CLDM) and ceftazidime hydrate (CAZ), following total excision for squamous cell carcinoma on her left face. Four days after drug administration, she developed asymptomatic erythema on her back that rapidly extended, covering her whole body over a 4-day period. Small pustules were also noted. Simultaneously, she experienced a high fever and hypouresis. We stopped the administration of CLDM and CAZ, and changed to meropenem (MEPM). Clinical symptoms and laboratory data improved remarkably ten days after changing the antibiotics. Drug lymphocyte stimulation tests (DLST) revealed both CLDM and CAZ as positive. Only CLDM was positive by patch testing. On the basis of these findings and the clinical course, we diagnosed this case as AGEP and acute kidney injury induced by CLDM and CAZ.