{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T18:05:42Z","timestamp":1780077942351,"version":"3.54.0"},"reference-count":13,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,9,30]]},"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:p>A 23-year-old man with a history of end-stage renal disease was admitted to the hospital due to fever and shock, which occurred during his dialysis. One week prior, he developed an erythematous rash on his chest, face and back, associated with generalised eruption of pustules. In hospital, his status did not improve with norepinephrine and empirical broad-spectrum antibiotics. Following this, methylprednisolone was administered with remarkable improvement. Cultures revealed no infectious aetiology. Based on the morphology of the rash and a compatible skin biopsy, the diagnosis of acute generalised exanthematous pustulosis (AGEP) was established and considered the cause of his shock. The causative agent of his AGEP remained unknown. AGEP is a rare condition, most frequently associated with drug exposure. The removal of the offending agent is the treatment of choice. It can be complicated by shock in rare cases. In that scenario, systemic corticosteroids seem to improve outcomes greatly.<\/jats:p>","DOI":"10.1136\/bcr-2020-235846","type":"journal-article","created":{"date-parts":[[2020,10,30]],"date-time":"2020-10-30T17:11:14Z","timestamp":1604077874000},"page":"e235846","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Acute generalised exanthematous pustulosis associated with shock"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9681-0515","authenticated-orcid":false,"given":"Philippos Apolinario","family":"Costa","sequence":"first","affiliation":[{"name":"Internal Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna Menon Loureiro Apolinario","family":"Costa","sequence":"additional","affiliation":[{"name":"Family Medicine, Universidade Federal do Vale do Sao Francisco, Petrolina, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Milikowski","sequence":"additional","affiliation":[{"name":"Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan E","family":"St Onge","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,10,30]]},"reference":[{"key":"2025082622453163000_13.10.e235846.1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.090137"},{"key":"2025082622453163000_13.10.e235846.2","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2017-220612","article-title":"An illusion of septic shock: acute generalised exanthematous pustulosis with multiorgan dysfunction","volume":"2017","author":"Jakkidi","year":"2017","journal-title":"BMJ Case Rep"},{"key":"2025082622453163000_13.10.e235846.3","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0560.2001.028003113.x"},{"key":"2025082622453163000_13.10.e235846.4","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1159\/000246286","article-title":"Acute generalized exanthematous pustulosis induced by paracetamol. 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