A Case of Sweet's Syndrome Presenting Clinical Conditions Closely Similar to Severe Sepsis
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We herein report a case of Sweet's syndrome presenting clinical conditions closely similar to severe sepsis. A 32-year old woman delivered a male infant with perineal incision. Since the next day, she revealed high fever with elevated WBC and CRP. Suspected of incisional infection, administration of antibiotics was initiated. Several days later, painful erythematous plaques were observed at the injection sites on her right shoulder and left forearm. Since continued administration of antibiotics failed to prevent respiratory and hemodynamic deterioration, she was admitted to the ICU on suspicion of severe sepsis. Though we performed repeated bacterial cultures of various specimens, all cultures were sterile. Since the patient did not respond to various antibiotics at all and showed negative cultivation test results, we suspected a disease other than microbial infection, and consulted a dermatologist concerning her painful erythematous plaques on her skin. As a result of this consultation, she was diagnosed with Sweet's syndrome, and her clinical condition similar to severe sepsis was ascribed to Sweet's syndrome. Her general condition and cutaneous lesions improved rapidly by systemic corticosteroid therapy against Sweet's syndrome. Sweet's syndrome is a relatively rare skin disease of unknown etiology, characterized by clinical manifestations suggestive of inflammation such as fever and leukocytosis as well as painful erythematous plaques. In a literature search, we identified only two documented cases of Sweet's syndrome with conditions closely resembling severe sepsis as in the present one. Although the etiology of this disease is unknown, its major pathologic features suggest possible contribution of cytokines, e.g., granulocyte colony-stimulating factor (G-CSF). Cases suspected of infection, but unresponsive to antibiotics and with negative bacterial cultures, may be due to Sweet's syndrome.
- 一般社団法人 日本救急医学会の論文
一般社団法人 日本救急医学会 | 論文
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