Introduction: Skin disorders are common in emergency department especially when associated with fever. Twenty five to forty percent are related to a decompensation of a preexisting skin disease . In 1964, Sweet describes a “strange eruption” which is immunologically mediated and since that date the dermatitis bears his name . In the emergency department, the diagnosis of this pathology may be difficult especially when the presentation is severe or associated with fever since it face the physician to a therapeutic dilemma: giving antibiotics or steroids.
Case presentation: A 43 years old man with no past medical history was transported to the emergency department by the mobile emergency service with a chief complaint of weakness and fever associated with a disseminated skin eruption. He was conscious but very weak and he has fever about 38.5°C. Systolic blood pressure/diastolic blood pressure was about 90/60 mmHg and heart rate about 96 per minute. Initially he was managed as severe septic syndrome since we found nitrites in urine sample associated with systemic inflammatory response syndrome (SIRS). A PCT was performed and the amount was less than 0.5 ng.mL-1 so we performed a skin biopsy which showed a neutrophilic infiltration consistent with Sweet syndrom. The patient was given steroids and had rapid improvement of his complaints.
Conclusion: Sweet syndrome is a possible diagnostic in patient with skin eruption and non infectious SIRS in the emergency department
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