Miliaria Crystallina Complicating Infectious Spondylodiscitis

Abstract

We report the case of miliaria crystallina complicating infectious spondylodiscitis in the lumbar region in a 66-year old woman. The eruption was concomitant with a persistent malignant fever and consisted of diffuse vesicular lesions spread all over the body with regress after resolution of fever.Miliaria crystallina is a benign cutaneous manifestation related to heat retention secondary to sweat duct obstruction following excessive exposure to heat, humidity, or hyperthermia (3). It is commonly found in newborns, especially in warm climates and tropical regions, but it may also occur in older individuals (1). Well-known causes include persistent febrile states and certain drugs such as bethanechol, salbutamol, and clonidine (4,5).We report the case of a 66-year-old Tunisian female patient with a past medical history of hypertension and chronic lymphocytic leukemia, hospitalized for pyogenic spondylodiscitis in the lumbar region. During her stay,the patient developed a persistent malignant fever resulting in the appearance of diffuse vesicular lesions measuring 1-3mm spread all over the body, with clear content, firm to palpation, on healthy skin, suggesting miliaria crystallina (figure a,b). These lesions were non-erythematous, non-tender, and fragile, with no oral involvement.Three days of initiating intravenous antibiotic therapy,The outcome was characterized by the resolution of fever and spontaneous regression of skin lesions.