Cefuroxime induced lymphomatoid hypersensitivity reaction. Issue 899 (1st September 2000)

• Record Type: Journal Article
• Authors: Saeed, S A M; Bazza, M; Zaman, M; Ryatt, K S
• Is Part Of: Postgraduate medical journal. Volume 76:Issue 899(2000)
• Page Start: 577
• Page End: 579
• Publication Date: 2000-09-01
• Subjects: cefuroxime -- atypical cutaneous lymphomatoid infiltrate -- cutaneous T cell lymphoma; Medicine -- Periodicals; 610
• DOI: 10.1136/pmj.76.899.577
• Languages: English
• ISSNs: 0032-5473

Abstract

Abstract : An 84 year old women developed erythematous blotchy erythema and purpuric rashes over the lower limbs three days after being started on intravenous cefuroxime for acute diverticulitis. A skin biopsy specimen showed a mixed infiltrate of lymphoid cells and eosinophils; many of the lymphocytes were large, pleomorphic, and showed a raised mitotic rate. Immunohistochemistry showed the infiltrate to be T cell rich, with all the large cells being CD30 positive. Typical mycosis fungoides cells, marked epidermotropism, and Pautrier's abscesses were not seen. The rash disappeared 10 days after cessation of cefuroxime and the patient remained asymptomatic 15 months later. This apparent cutaneous T cell lymphoma-like reaction is best described as lymphomatoid vascular reaction. The drug induced immune response with an atypical cutaneous lymphoid infiltrate mimics a cutaneous pseudolymphoma.