Abstract
IntroductionSweet's syndrome characterized by fever, blood neutrophilia and inflammatory skin lesions, is rarely diagnosed in children. It presents in three clinical settings: classical Sweet's syndrome, usually after a respiratory tract infection; malignancy-associated, frequently related to acute myelogeneous leukemia; and drug-induced. We present, to the best of our knowledge, the first case of a rotavirus -infection-related Sweet's syndrome.Case presentationAn 18-month-old boy of Hellenic origin was referred to us with diarrhea, fever, neutrophilia, typical skin lesions, asymmetrical hip arthritis and oropharyngeal involvement. A skin biopsy confirmed the diagnosis. Thorough screening did not reveal any underlying systemic illness, except for the confirmation of an overt rotavirus infection. The syndrome responded promptly upon corticosteroid administration; no recurrence was observed.ConclusionBesides describing the connection of Sweet's syndrome to a rotavirus infection, this case report is also a reminder that in a child presenting with a febrile papulo-nodular rash with neutrophilia Sweet's syndrome should be included in the differential.
Highlights
Sweet’s syndrome characterized by fever, blood neutrophilia and inflammatory skin lesions, is rarely diagnosed in children
Sweet’s syndrome is characterized by a constellation of clinical symptoms and physical findings, which include fever, blood and tissue neutrophilia, leading to the development of tender, erythematous inflammatory skin lesions, histopathologically characterized by the presence of abundant mature neutrophils [1]. It presents in three clinical settings: ‘classical’ (’para-infectious’) Sweet’s syndrome, representing a hypersensitivity reaction preceding infection; malignancy-associated (’para-neoplastic’) Sweet’s syndrome; and less frequently as an adverse drug reaction, sometimes in connection with certain underlying diseases [2]
Case presentation An 18-month-old boy of Hellenic origin was initially admitted to another hospital because of fever up to 39.9°C lasting for five days, a mild cough, one to two vomits and two to three yellowish diarrheas per day
Summary
Sweet’s syndrome (acute febrile neutrophilic dermatosis) is characterized by a constellation of clinical symptoms and physical findings, which include fever, blood and tissue neutrophilia, leading to the development of tender, erythematous inflammatory skin lesions (papules, nodules, plaques), histopathologically characterized by the presence of abundant mature neutrophils [1]. Antibiotic and antiviral medications were discontinued and intravenous prednisone (1 mg/kg body weight/24 h) was administered for 10 days with immediate cessation of the fever and gradual improvement of the skin lesions, the hip complaints and the laboratory findings (Table 1). After six months of follow-up no recurrence has been observed and the child is thriving
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