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Case Reports
. 2025 May 9;17(5):e83786.
doi: 10.7759/cureus.83786. eCollection 2025 May.

Piperacillin-Tazobactam-Induced Generalized Exanthematous Pustulosis

Sudeep Chapagain  1 , Prabina Basnet  1 , Surendra Khanal  1 , Zahraa Rabeeah  1 , Njika Atemnkeng  1
Affiliations
Case Reports

Piperacillin-Tazobactam-Induced Generalized Exanthematous Pustulosis

Sudeep Chapagain et al. Cureus. .

Abstract

Acute generalized exanthematous pustulosis (AGEP) is an extremely rare condition that is mostly caused by antibiotic exposure. Clinically, it manifests as the rapid appearance of multiple sterile pustules, swelling, and erythema within a few hours to days of exposure to the offending medication. Skin lesions usually resolve by desquamation after discontinuation of the offending agent. We present a case of a 58-year-old female patient with AGEP in the setting of piperacillin-tazobactam use, which was confirmed by histopathology with findings of neutrophilic pustules and eosinophilic infiltration. Her symptoms started resolving within three days of stopping the medication.

Keywords: acute generalized exanthematous pustulosis; beta-lactam; beta-lactam antibiotics; cutaneous drug reaction; fever; piperacillin-tazobactam.

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Conflict of interest statement

Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Maculopapular and pustular rash over bilateral forearms (A, B) and trunk (C) from left to right
Figure 2
Figure 2. Biopsy images of the skin lesion from the right leg
(A) The arrow shows a pustule in the epidermis; (B) neutrophils in the epidermis and a few necrotic keratinocytes; (C) eosinophils in the dermis
See this image and copyright information in PMC

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