Sweet’s syndrome presenting with mild skin eruption *
A 15-year-old Japanese girl visited the Department of Emergency Medicine of our hospital with a sore throat and a temperature of more than 39℃. Her white blood cell count was 11,100/mm3 with 87％ neutrophils. C-reactive protein in 15.2 mg/dl was positive. From these findings, a provisional diagnosis of bacterial infection was made. However, treatment with antibiotics did not improve her symptoms. Painful reddish plaques, 1cm in diameter, were observed on her face and chest two days after admission. Histological examination revealed an infiltrate consisting of mononuclear cells and numerous neutrophils in the dermis. A diagnosis of Sweet's syndrome was made on the basis of clinical signs, and laboratory and histopathological findings. The patient was intravenously given 60mg of prednisolone daily, and there was a striking clinical improvement. High fever, neutrophilia, and elevated C-reactive protein are most suggestive of bacterial infection, but Sweet's syndrome should also be considered as a differential diagnosis. (Accepted on July 20，2004)
