An 11-year-old boy was hospitalized for atopic dermatitis with secondary bacterial infection. He showed multiple erythematous crusted patches on both legs for 2 weeks (Figure 1). On initial admission, the patient denied having headaches or a sore throat; he had no fever. His antistreptolysin-O titer was normal (127 IU/mL; normal range, 0-243 IU/mL), and group A β-hemolytic Streptococcus (GABS) was identified through cultures of the cutaneous lesions. Although the skin lesions improved under treatment with intravenous cefazoline sodium, he complained of a headache and was subsequently found to have high blood pressure (150/90 mm Hg) from hospital day 3. After the blood pressure was controlled with sublingual nifedipine, he was discharged on hospital day 5.
Park JM, Oh SH, Kim J, Lee JH. Atopic Dermatitis With Group A β-Hemolytic Streptococcus Skin Infection Complicated by Posterior Reversible Encephalopathy Syndrome. Arch Dermatol. 2009;145(7):846-847. doi:10.1001/archdermatol.2009.129