Death Associate with Sweet's Syndrome / 대한법의학회지

ABSTRACT

Sweet's syndrome was originally described as an "acute febrile neutrophilic dermatosis". Sweet's syndrome presents in three clinically settings (1) classical or idiopathic Sweet's syndrome, (2) malignancyassociated or paraneoplastic Sweet's syndrome, (3) drug-induced Sweet's syndrome. Sweet's syndrome is known to respond well to systemic corticosteroids, and mortal case associated without any other predisposing factors is hardly found. Twenty-nine year old male was transferred from local clinic with the chief complaint of recurrent thrombophlebitis which occurred 10 days ago after IV treatment of antibiotics for burn. The symptom did not get well with conventional treatment for the thrombophlebitis such as antibiotics or drainage. After several days of pyrexia, the patient died suddenly. Grossly abnormal findings including pulmonary thrombus which could explain sudden death were not found. Disseminated intravascular microthrombi was the most peculiar finding. It was prominent in small sized vein, and lung was the most severely affected. Heart and liver were also involved. Large thrombi within deep vein of the legs were also noted. Minor collections of inflammatory cells, even apart from the main lesion, were noted in skin adnexa or small vessles within aorta wall. No tumorous area was found. The disseminated intravascular coagulation, which was associated with vasculitis was thought to be the direct cause of death. Several points about the Sweet's syndrome including the unusualness of this case were discussed.