Case Reports
25 February 2025

Generalized bullous drug eruption triggered by ceftriaxone: a case report and literature overview

Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
308
Views
206
Downloads

Authors

Ceftriaxone is a widely used third-generation cephalosporin antibiotic known for its efficacy and safety. However, hypersensitivity reactions, including rare cases of generalized bullous fixed drug eruption (GBFDE), have been reported. We present the case of a 68-year-old female with a history of multiple comorbidities who developed a generalized bullous drug eruption two days after initiating intravenous ceftriaxone for a suspected respiratory infection. Clinical evaluation revealed extensive bullae and erythematous patches sparing mucous membranes, with histopathology confirming drug-induced epidermal changes. Direct immunofluorescence ruled out autoimmune bullous disorders. Prompt discontinuation of ceftriaxone, systemic corticosteroids, and supportive topical treatments led to marked clinical improvement. This case underscores the importance of recognizing rare but severe cutaneous reactions to ceftriaxone. Early diagnosis and intervention are crucial to minimizing complications and ensuring favorable outcomes.

Altmetrics

Downloads

Download data is not yet available.

Citations

Richards DM, Heel RC, Brogden RN, et al. Ceftriaxone. A review of its antibacterial activity, pharmacological properties and therapeutic use. Drugs 1984;27:469-527. DOI: https://doi.org/10.2165/00003495-198427060-00001
Ozkaya E, Mirzoyeva L, Jhaish MS. Ceftriaxone-induced fixed drug eruption: first report. Am J Clin Dermatol 2008;9:345-7. DOI: https://doi.org/10.2165/00128071-200809050-00011
Al-Ansari RY, Almuhaish LA, Hassan KA, et al. A Saudi Woman with Ceftriaxone Induced Fixed Drug Eruption. Case Rep Dermatol Med 2024;2024:9975455. DOI: https://doi.org/10.1155/2024/9975455
Guleria VS, Dhillon M, Gill S, Naithani N. Ceftriaxone induced drug rash with eosinophilia and systemic symptoms. J Res Pharm Pract 2014;3:72-4. DOI: https://doi.org/10.4103/2279-042X.137077
Shah MM, Dhanani S, Patel K, Nair P. Acute generalized exanthematous pustulosis following ceftriaxone. Indian J Pharmacol 2024;56:297-8. DOI: https://doi.org/10.4103/ijp.ijp_127_24
Lee JH, Ju IN, Cho HJ, et al. Toxic Epidermal Necrolysis by Ceftriaxone in Patient with Newly Diagnosed Systemic Lupus Erythematosus. Journal of Rheumatic Diseases. 2013;20:374-7. DOI: https://doi.org/10.4078/jrd.2013.20.6.374
Rathva T, Sinha A, Solanki V, Kanjariya D. A case of generalized bullous fixed drug eruptions induced by ceftriaxone. Int J Basic Clin Pharmacol [Internet] 2024[cited 2024 Oct. 23];13:726-8. Available from: https://www.ijbcp.com/index.php/ijbcp/article/view/5695 DOI: https://doi.org/10.18203/2319-2003.ijbcp20242437
Anderson HJ, Lee JB. A Review of Fixed Drug Eruption with a Special Focus on Generalized Bullous Fixed Drug Eruption. Medicina (Kaunas) 2021;57:925. DOI: https://doi.org/10.3390/medicina57090925
Verheyden MJ, Bilgic A, Murrell DF. A Systematic Review of Drug-Induced Pemphigoid. Acta Derm Venereol 2020;100:adv00224. DOI: https://doi.org/10.2340/00015555-3457
Liu SD, Chen WT, Chi CC. Association Between Medication Use and Bullous Pemphigoid: A Systematic Review and Meta-analysis. JAMA Dermatol 2020;156:891-900. DOI: https://doi.org/10.1001/jamadermatol.2020.1587

How to Cite



Generalized bullous drug eruption triggered by ceftriaxone: a case report and literature overview. (2025). Dermatology Reports. https://doi.org/10.4081/dr.2025.10208