The potential utility of patch testing in identifying the causative agent of morbilliform drug eruptions.

摘要

A 45-year-old female with acute myelogenous leukemia was admitted with neutropenic fever after re-induction chemotherapy for leukemic relapse. She was empirically treated with vancomycin, meropenem, and piperacillin-tazobactam. The dermatology department was consulted after she developed fevers and a pruritic generalized morbilliform eruption with petechiae in dependent areas (Fig 1). The petechiae began to fade, but the original eruption subsequently developed darkening and confluence. Her antibiotic was changed again (to gentamicin), and the rash eventually faded. The hematologist was concerned that the patient might need empiric antibiotics in the future if neutropenic fevers developed again. The patient was referred for patch testing to determine which medications could still be used in the future.