AI Summary & Key Takeaways
AI InsightG-CSF treatment was discontinued and intravenous steroids were started wit resultant control of fever, and resolution of the rash Sweet syndrome should be kept in mind when erythematous rashes develop in patients with febrile neutropenia who have been using G-CSF for a long time and who have not been able to control their fever despite appropriate antibiotics and antifungals.
📌 3 Key Takeaways
Abstract
Sweet syndrome is a rarely seen disease characterized with fever, arthralgia, neutrophilic leukocytosis and painful erythematous plaques, and dense neutrophilic inifltration in dermis at lesion sites which occur mostly on the face and upper extremities. A nine-year-old girl with a diagnosis of acute lymphoblastic leukemia was admitted to the hospital with high fever. Empirical broad spectrum antibiotic and granulocyte-colony stimulating factor (G-CSF) treatments were initiated for febrile neutropenia. Although antifungal therapy was added to the treatment during follow-up, hyperfebrile state could not be resolved. On the 14th day of G-CSF treatment, the result of the skin biopsy performed from red, painful eruptions seen on the legs was compatible with Sweet syndrome. G-CSF treatment was discontinued and intravenous steroids were started wit resultant control of fever, and resolution of the rash Sweet syndrome should be kept in mind when erythematous rashes develop in patients with febrile neutropenia who have been using G-CSF for a long time and who have not been able to control their fever despite appropriate antibiotics and antifungals.
Özet
Sweet sendromu ateş, artralji, nötrofilik lökositoz ve daha çok yüzde ve üst ekstremitelerde ortaya çıkan ağrılı eritamatöz plaklar ve bu lezyon bölgelerinde dermiste yoğun nötrofilik infiltrasyon ile karakterize nadir görülen bir deri hastalığıdır. Akut lenfoblatik lösemi tanısıyla tedavisi devam eden dokuz yaşında kız hasta yüksek ateş nedeni ile yatırıldı. Febril nötropeniye yönelik ampirik geniş spektrumlu antibiyotik ve granülosit koloni uyarıcı faktör (G-CSF) tedavileri başlandı. İzleminde antifungal tedavi eklenmesine rağmen, ateş yüksekliği kontrol altına alınamadı. G-CSF tedavisinin 14. gününde bacaklarda ortaya çıkan kırmızı, ağrılı döküntülerin biyopsisi sonucu Sweet sendromu ile uyumlu geldi. G-CSF tedavisi kesilerek intravenöz steroid başlanan olguda ateş kontrol altına alındı ve döküntüler kayboldu. Uzun süre G-CSF kullanan ve uygun antibiyotik ve antifungallere rağmen, ateşi konrol altına alınamayan febril nötropenili hastalarda, eritematöz döküntüler geliştiğinde, Sweet sendromu akılda bulundurulmalıdır.