Sweet syndrome presents with severe SIRS

MAJED K, ZAOUCHE KH, MAGHRAOUI H, BACCOUCHE R, HAMOUDA CH, FALFOUL N. Sweet syndrome presents with severe SIRS. Med Emergency, MJEM 2018; 26:19-21.

DOI 10.26738/MJEM.2017/mjem26.2018/MK.CRE.220217

Key words: SIRS, skin disorder, sweet syndrome
  • Authors’ affiliation
  • Article history / info
  • Conflict of interest statement
Correspondent author: Kamel MAJED, MD

Emergency medicine department, Rabta teaching hospital,

Tunis 1007 Tunis, Tunisia


Majed K, MD, Zaouche Kh, MD, Maghraoui H, MD, Baccouche R, MD, Hamouda Ch, PhD, Falfoul N, PhD

Emergency medicine department, Rabta teaching hospital, Tunis, Tunisia

Category: Case report

Received: Dec. 14, 2016

Revised: Feb. 01, 2017

Accepted: Feb. 22, 2017

There is no conflict of interest to declare


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 [1]. In 1964, Sweet describes a “strange eruption” which is immunologically mediated and since that date the dermatitis bears his name [2]. 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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