# Rifampicin‐Associated Sweet Syndrome: An Uncommon Adverse Event of Anti‐Tuberculosis Therapy

## TL;DR

A 58-year-old man with tuberculosis developed a rare skin condition called Sweet syndrome, which was linked to the drug rifampicin.

## Contribution

This case confirms rifampicin as a rare but important cause of Sweet syndrome in tuberculosis patients.

## Key findings

- The patient's skin condition improved with corticosteroids but recurred when rifampicin was reintroduced.
- Rifampicin was discontinued, and the patient successfully completed tuberculosis treatment with other drugs.
- Accurate diagnosis helps avoid unnecessary drug discontinuation in tuberculosis therapy.

## Abstract

Sweet syndrome, or acute febrile neutrophilic dermatosis, is an uncommon inflammatory condition that may arise secondary to infection, malignancy, autoimmune disease, or drugs. Its association with tuberculosis is rare, and rifampicin‐induced Sweet syndrome has been infrequently reported. We present a 58‐year‐old man with disseminated tuberculosis who developed painful erythematous plaques shortly after commencing antituberculous therapy (ATT). The eruption improved with corticosteroids but recurred specifically on rechallenge with rifampicin, confirming a drug‐induced aetiology. Rifampicin was excluded, and the patient completed ATT successfully with the remaining first‐line drugs. Rifampicin‐induced Sweet syndrome is a rare but important differential in patients who develop erythematous plaques on ATT. Accurate diagnosis allows continuation of essential tuberculosis treatment while avoiding unnecessary discontinuation of other first‐line drugs.

We present a 58‐year‐old man with disseminated tuberculosis who developed painful erythematous plaques shortly after commencing antituberculous therapy (ATT). The eruption improved with corticosteroids but recurred specifically on rechallenge with rifampicin, confirming a drug‐induced aetiology. Rifampicin was excluded, and the patient completed ATT successfully with the remaining first‐line drugs. Rifampicin‐induced Sweet syndrome is a rare but important differential in patients who develop erythematous plaques on ATT. Accurate diagnosis allows continuation of essential tuberculosis treatment while avoiding unnecessary discontinuation of other first‐line drugs.