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Maculopapular exanthema: case report A 33-year-old man developed maculopapular exanthema during treatment with clindamycin and piperacillin/tazobactam. The man, who had no known personal history, presented to emergency room with a painful submandibular swelling associated with fever and compromised feeding and speech. He underwent several laboratory tests, and he was diagnosed with Ludwig’s angina. Cervicotomy was performed to drain the submandibular abscess and he was intubated. He was initiated on clindamycin and piperacillin/tazobactam [routes and dosages not stated] with the identification of Staphylococcus epidermidis and Streptococcus anginosus in the abscess pus, without bacteriological isolation in blood cultures. Later, he developed maculopapular exanthema of the anterior region of the thorax, with progressive worsening, subsequently reaching the back, thighs and lower region of the abdomen, without visible mucosal involvement [duration of treatment to reaction onset and outcome not stated]. The man’s treatment with clindamycin and piperacillin/tazobactam was discontinued due to probable drug toxidermia, and he was initiated on vancomycin and metronidazole. He also received methylprednisolone and clemastine. He was extubated after 408 hours of invasive mechanical ventilation. On day 19, all antibiotics were stopped due to clinical improvement, sustained apyrexia and negative analytical parameters of infection. He was discharged from the hospital against medical advice and did not attended any follow-up appointments. Duarte P, et al. Ludwig’s Angina, a clinical case report. Revista Portuguesa de Estomatologia, Medicina Dentaria e Cirurgia Maxilofacial 61: 29-32, No. 1, 20 Jul 2020. 803520596 Available from: URL: http://doi.org/10.24873/j.rpemd.2020.07.698 [Portuguese; summarised from a translation]

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Reactions 12 Dec 2020 No. 1834