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July 2009

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

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.