The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

Disseminated Gonococcal Infection Presenting as Sweet Syndrome

Sweet 증후군으로 발현한 파종성 임균감염

  • Kim, Joon-Wan (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Song, Ran (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Im, Churl-Hyun (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Kim, Jin-Hyun (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Lee, Eun-Young (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Lee, Eun-Bong (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Song, Yeong-Wook (Department of Internal Medicine, Seoul National University College of Medicine)
  • 김준완 (서울대학교 의과대학 내과학교실) ;
  • 송란 (서울대학교 의과대학 내과학교실) ;
  • 임철현 (서울대학교 의과대학 내과학교실) ;
  • 김진현 (서울대학교 의과대학 내과학교실) ;
  • 이은영 (서울대학교 의과대학 내과학교실) ;
  • 이은봉 (서울대학교 의과대학 내과학교실) ;
  • 송영욱 (서울대학교 의과대학 내과학교실)
  • Published : 2011.04.01
⟨ Previous Next ⟩

Abstract

The salient features of Sweet syndrome, also known as acute febrile neutrophilic dermatosis, are pyrexia, elevated neutrophil count, painful red papules, nodules, plaques, and an infiltrate that consists mainly of mature neutrophils diffusely distributed in the upper dermis. In addition to idiopathic forms of the syndrome, malignancies, inflammatory bowel disease, infections, pregnancy, and drugs have been associated with Sweet syndrome. Disseminated gonococcal infection (DGI) results from bacteremic dissemination of Neisseria gonorrhoeae. The most common presentation of DGI is arthritis-dermatitis syndrome. About 75% of DGI patients display a characteristic dermatitis consisting of discrete papules and pustules, often with a hemorrhagic component. We report a case of DGI presenting as Sweet syndrome.

Sweet 증후군은 특발성 이외에도 악성종양, 염증장병, 감염, 임신, 약물 등과 관련되어 발생할 수 있다. 파종성 임균감염은 발열, 백혈구 증가, 동통을 동반한 피부 발진 등의 임상양상과 피부 조직소견이 Sweet 증후군과 유사할 수 있다. 본 저자들은 전형적인 피부 소견을 보이지 않고 Sweet 증후군으로 발현한 파종성 임균감염을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Sweet RD. Acute febrile neutrophilic dermatosis: 1978. Br J Dermatol 1979;100:93-99. https://doi.org/10.1111/j.1365-2133.1979.tb03573.x
  2. Cohen PR, Almeida L, Kurzrock R. Acute febrile neutrophilic dermatosis. Am Fam Physician 1989;39:199-204.
  3. Fett DL, Gibson LE, Su WP. Sweet's syndrome: systemic signs and symptoms and associated disorders. Mayo Clin Proc 1995;70:234-240. https://doi.org/10.4065/70.3.234
  4. Cohen PR, Kurzrock R. Sweet's syndrome and cancer. Clin Dermatol 1993;11:149-157. https://doi.org/10.1016/0738-081X(93)90112-P
  5. Walker DC, Cohen PR. Trimethoprim-sulfamethoxazole-associated acute febrile neutrophilic dermatosis: case report and review of drug-induced Sweet's syndrome. J Am Acad Dermatol 1996;34:918-923. https://doi.org/10.1016/S0190-9622(96)90080-8
  6. Kemmett D, Hunter JA. Sweet's syndrome: a clinicopathologic review of twenty-nine cases. J Am Acad Dermatol 1990;23:503-507. https://doi.org/10.1016/0190-9622(90)70250-L
  7. Sitjas D, Puig L, Cuatrecasas M, De Moragas JM. Acute febrile neutrophilic dermatosis (Sweet's syndrome). Int J Dermatol 1993;32:261-268. https://doi.org/10.1111/j.1365-4362.1993.tb04265.x
  8. Hommel L, Harms M, Saurat JH. The incidence of Sweet's syndrome in Geneva: a retrospective study of 29 cases. Dermatology 1993;187:303-305. https://doi.org/10.1159/000247276
  9. von den Driesch P. Sweet's syndrome (acute febrile neutrophilic dermatosis). J Am Acad Dermatol 1994;31:535-556; quiz 557-560. https://doi.org/10.1016/S0190-9622(94)70215-2
  10. Chan HL, Lee YS, Kuo TT. Sweet's syndrome: clinicopathologic study of eleven cases. Int J Dermatol 1994;33:425-432. https://doi.org/10.1111/j.1365-4362.1994.tb04045.x
  11. Handfield HH, Sparling PF. Neisseria gonorrhoeae. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Disease. 6th ed. Philadelphia: Elsevier Churchill Livingstone, 2005:2522-2524.
  12. Ram S, Rice PA. Gonococcal infections. In: Fauci AS, Kasper DL, Braunwald E, et al., eds. Harrison's Principles of Internal Medicine. 17th Ed. New York: McGraw-Hill, 2008:918.
  13. Cohen PR, Holder WR, Rapini RP. Concurrent Sweet's syndrome and erythema nodosum: a report, world literature review and mechanism of pathogenesis. J Rheumatol 1992;19:814-820.
  14. Cohen PR, Kurzrock R. The pathogenesis of Sweet's syndrome. J Am Acad Dermatol 1991;25:734. https://doi.org/10.1016/S0190-9622(08)80689-5
  15. Britigan BE, Cohen MS, Sparling PF. Gonococcal infection: a model of molecular pathogenesis. N Engl J Med 1985;312:1683-1694. https://doi.org/10.1056/NEJM198506273122606
  16. Bardin T. Gonococcal arthritis. Best Pract Res Clin Rheumatol 2003;17:201-208. https://doi.org/10.1016/S1521-6942(02)00125-0
  17. Read P, Abbott R, Pantelidis P, Peters BS, White JA. Disseminated gonococcal infection in a homosexual man diagnosed by nucleic acid amplification testing from a skin lesion swab. Sex Transm Infect 2008;84:348-349. https://doi.org/10.1136/sti.2008.030817
  18. Jain S, Win HN, Chalam V, Yee L. Disseminated gonococcal infection presenting as vasculitis: a case report. J Clin Pathol 2007;60:90-91. https://doi.org/10.1136/jcp.2005.034546
  19. Mastrolonardo M, Loconsole F, Conte A, Rantuccio F. Cutaneous vasculitis as the sole manifestation of disseminated gonococcal infection: case report. Genitourin Med 1994;70:130-131.