Acute generalised exanthematous pustulosis (AGEP) is an unusual cutaneous reaction, most often related with a hypersensitivity reaction to commonly used drugs. It is characterized by an abrupt onset of a pustular rash within hours or days after drug exposure and usually resolves spontaneously within 1-2 weeks after drug discontinuation. Some cases associated with systemic involvement and shock have been reported. We present the case of a severe AGEP, manifesting in association with systemic involvement and haemodynamic instability resulting in shock and multiorgan dysfunction in an adult female patient diagnosed with COVID-19 infection. There were no identifiable associated drugs, and the patient was not initiated on antimalarial drugs. Our patient improved rapidly, both hemodynamically and dermatologically with no directed therapy.
Las discrasias hemáticas inducidas por fármacos, son causadas por la interacción de diferentes fármacos con las células hematopoyéticas por medio de receptores específicos. Otros mecanismos fisiopatológicos pueden ser por toxicidad directa sobre la médula ósea o las células periféricas, por hipersensibilidad, por defectos inmunológicos secundarios a infecciones virales, por mecanismos mixtos o desconocidos. Las primeras asociaciones se describieron en la década de los años treinta.
Los fármacos con mayor riesgo relativo de agranulocitosis o anemia aplásica son los antitiroideos, carbamazepina, las sulfonilureas, la indometacina, el piroxicam, entre otros. Se presenta a continuación el reporte de un caso clínico en paciente adulto quien con la administración de vancomicina presentó agranulocitosis resolviendo el cuadro posterior a su suspensión
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