Acute generalized exanthematous pustulosis induced by meropenem: An unusual side effect and review of literature

Extensive formation of non-follicular sterile pustules on erythematous background combined with fever and peripheral blood leukocytosis are the characteristics of acute generalized exanthematous pustulosis (AGEP). It is a rare skin rash, usually secondary to a drug reaction and shares several clinical and histological features in common with pustular psoriasis. Most reported cases have been triggered by ingestion of broad spectrum antibiotics, particularly betalactams and macrolides. We report a 45-year-old male who developed AGEP shortly after commencing treatment with meropenem for chest infection. Skin biopsy revealed subcorneal pustules filled with neutrophils, mixed perivascular infiltrate as well as mild dermal edema. There was no evidence of vasculitis. The eruption improved after cessation of the offending drug and a short course of systemic corticosteroids. To our knowledge, this is the second case of meropenem-induced AGEP in English-language literature