Case Report
Sweet Syndrome Associated with Furosemide
Abstract
This case report describes a case of Sweet syndrome (SS) related to use of furosemide in a 46-year-old female who was admitted for treatment of congestive heart failure. Three days after administration of furosemide, the patient had a fever and a skin eruption appeared on her wrists, forearms, and legs. Biopsy of the skin lesion was consistent with SS. Infection was thought to be unlikely because of negative blood cultures, echocardiography, and other imaging studies. Careful review of her medications revealed that the patient received furosemide before the appearance of the skin eruption and fever. After discontinuation of furosemide, the patient's skin lesion and fever resolved. A MEDLINE search from June 1966 to May 2004 revealed only one reference documenting the association of SS with furosemide administration. Patients who have development of SS without an obvious cause should have their medication list closely reviewed.
Key Points
* Sweet syndrome is the prototype of acute neutrophilic dermatosis.
* The pathogenesis of Sweet syndrome remains unknown; cytokine dysregulation could account for most of the clinical, pathologic, and laboratory changes seen in Sweet syndrome.
* Sweet syndrome can be associated with infections, malignancies, autoimmune disorders, and drugs.
* The medical literature has established criteria for the diagnosis of Sweet syndrome including that secondary to drug administration.
* Careful review of a patient's medication usage is required in a patient who has development of Sweet syndrome without obvious cause.
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