Acute generalised exanthematous pustulosis in a child

Acute generalised exanthematous pustulosis (AGEP) is a rare cutaneous adverse reaction which is caused due to drugs or other triggers in children. We report a very rare case of AGEP after introduction of oral cefixime for a female child who presented with complaints of fever, cough and cold for 6 days. It was noted that she developed a rash over the face within 24 hours and within the following few hours, it spread over the neck, in the axilla and over the groin. The patient has no history of allergy and had no history of similar reaction in the past. On examination, the patient was vitally stable with no sign of shock or any other significant systemic findings. The rash was characterised by erythematous base with multiple pinpoint pustules and culture of those was sterile. Haemogram was suggestive of mild leucocytosis with normal liver and renal functions. Treatment included stopping the triggering medication, that is, syrup cefixime and starting the child on oral corticosteroids along with antihistamines. The child started improving within 48 hours of medication, and rashes recovered with desquamation. AGEP is an adverse reaction which is rarely noted in children. It is treated with oral corticosteroids and supportive care of the local lesions.