Sweet Syndrome due to G-CSF Use in Children with Acute Lymphoblastic Leukemia: Case Report
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Sweet syndrome is a rarely seen disease characterized with fever, arthrolgia, neutrophilic leukocytosis and painful erythematous plaques, and dense neutrophilic inifltration in dermis at lesion sites which occur mostly on the face and upper extremities. A nine-year-old girl with a diagnosis of acute lymphoblastic leukemia was admitted to the hospital with high fever. Empirical broad spectrum antibiotic and granulocyte-colony stimulating factor (G-CSF) treatments were initiated for febrile neutropenia. Although antifungal therapy was added to the treatment during follow-up, hyperfebrile state could not be resolved. On the 14th day of G-CSF treatment, the result of the skin biopsy performed from red, painful eruptions seen on the legs was compatible with Sweet syndrome. G-CSF treatment was discontinued and intravenous steroids were started wit resultant control of fever, and resolution of the rash Sweet syndrome should be kept in mind when erythematous rashes develop in patients with febrile neutropenia who have been using G-CSF for a long time and who have not been able to control their fever despite appropriate antibiotics and antifungals.