title: Systemic inflammatory response syndrome associated with Sweet's syndrome.
abstract: PURPOSE: To describe the first pediatric report of systemic inflammatory response syndrome, shock, and multiple organ dysfunction syndrome associated with Sweet's syndrome. DESIGN: Case report. SETTING: Pediatric intensive care unit. PATIENTS: A patient with Sweet's syndrome and multiple organ dysfunction syndrome. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: We report the case of a 7-yr-old female child with an acute nonlymphoblastic leukemia in complete remission after an autologous bone marrow transplantation, with a clinical picture of skin lesions and fever that met the criteria of Sweet's syndrome and developing systemic inflammatory response syndrome, septic shock, and multiple organ dysfunction syndrome. Her clinical condition worsened despite broad-spectrum antimicrobial therapy and standard measures of cardiovascular support. An infectious site could not be identified, and all culture results were negative. Her condition improved dramatically once steroid therapy was administered, and she made a full recovery. CONCLUSION: Although it is a rare condition, the diagnosis of Sweet's syndrome must be considered in a patient with the typical skin lesions and systemic inflammatory response syndrome. The correct diagnosis is of great clinical importance, because therapy with systemic steroids results in a fast and remarkable improvement.
authors.affiliation: Pediatric Intensive Care Unit (EO, PR, JLV, IM), Pathology Department, Dermatology Department, and Pediatric Hematology-Oncology Unit, Hospital Universitario Ramón y Cajal, Alcalá de Henares University, Madrid, Spain. E-mail: eotheodetejada@hrc.insalud.es
authors.forename: Enrique
authors.initials: E
authors.lastname: Otheo
authors.forename: Purificación
authors.initials: P
authors.lastname: Ros
authors.forename: José L.
authors.initials: JL
authors.lastname: Vázquez
authors.forename: Rosario
authors.initials: R
authors.lastname: Carrillo
authors.forename: Ramón
authors.initials: R
authors.lastname: Moreno
authors.forename: Soledad
authors.initials: S
authors.lastname: Maldonado
authors.forename: Isabel
authors.initials: I
authors.lastname: Martos