Case Report Piperacillin/Tazobactam as Cause of Acute Generalized Exanthematous Pustulosis Aikaterini Kyriakou , 1 Sofia-Chrysovalantou Zagalioti, 2 Aikaterini Patsatsi , 1 Nikiforos Galanis, 3 and Elizabeth Lazaridou 1 1 Second Department of Dermatology and Venereology, Medical School, Aristotle University of Tessaloniki, Greece 2 Papageorgiou Hospital, Tessaloniki, Greece 3 Department of Orthopedics, Medical School, Aristotle University of Tessaloniki, Greece Correspondence should be addressed to Aikaterini Kyriakou; docmouli@gmail.com Received 27 October 2018; Revised 31 March 2019; Accepted 16 April 2019; Published 24 April 2019 Academic Editor: Ioannis D. Bassukas Copyright © 2019 Aikaterini Kyriakou et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Acute generalized exanthematous pustulosis (AGEP) is a rare cutaneous adverse reaction mainly attributed to antibiotics. It is characterized by numerous, nonfollicular, sterile pustules, arising on an exanthematous and edematous base. It is a serious adverse reaction accompanied by fever and leukocytosis. Piperacillin/tazobactam is indicated for the treatment of patients with moderate to severe infections. Herein is reported a case of AGEP caused by piperacillin/tazobactam. A 78-year-old woman with metastatic breast cancer was presented to the emergency department reporting fever and groin pain. Te laboratory analysis and more specifcally urine cultivation showed a urinary tract infection by E. coli with sensitivity to piperacillin/tazobactam. She had no known allergies. She was started on intravenous piperacillin/tazobactam; she improved clinically on the second day, but on the fourth day of intravenous therapy, she developed extensive pustular rash on the folds and anterior proximal thighs, accompanied by fever and neutrophilia. Piperacillin/tazobactam administration was interrupted and she was given prednisolone for ten days. Te patient improved clinically and her laboratory tests returned to normal afer two weeks. AGEP is an uncommon side efect of piperacillin/tazobactam treatment and there are few cases reported. 1. Introduction Acute generalized exanthematous pustulosis (AGEP) is a rare and severe cutaneous adverse reaction. Its incidence is estimated to be one to fve cases per million people per year [1]. Te vast majority of the cases reported in the literature are attributed to antibiotics, mainly penicillin and macrolide [2]. However, viral infection, UV radiation, and hypersensitivity reaction to mercury have also been reported as uncommon causes of AGEP [3]. It is presented with an abrupt onset of numerous, nonfollicular, sterile pustules, arising on an erythematous and edematous base [4–6]. Te lesions are preferentially located either on the face or on the intertriginous areas; then they spread to the trunk and limbs within a few hours [3]. Latency time for antibiotics is generally short, while for other drugs it is longer [1], and rash is accompanied by fever and leukocytosis with neutrophilia [2, 5, 6]. Piperacillin/tazobactam is an antibiotic indicated for the treatment of patients with moderate to severe infections [7]. A case of a patient who developed this rare condition with the use of piperacillin/tazobactam is presented and discussed. 2. Case Presentation A 78-year-old, Caucasian female patient with metastatic breast cancer under chemotherapy was presented to the emergency department reporting fever, groin pain, vomiting (over 10 times per day) and being unable to get up of the bed for the past four days afer the last chemotherapy. Te initial laboratory workup revealed increased serum creatinine level of 3.20 mg/dl (GFR=14.89 mL/min/1.73m2, baseline= 0.57- 1.11). Moreover, the urine analysis showed increased pyocytes (>100), while the urine cultivation highlighted E. coli with sensitivity to piperacillin/tazobactam. Hindawi Case Reports in Dermatological Medicine Volume 2019, Article ID 3273987, 3 pages https://doi.org/10.1155/2019/3273987