A 30-Year-Old Woman with Postpartum Fever, Abdominal Pain, and Skin Ulcers

This case concerns a 30-year-old woman, six days postpartum, presenting with fever, abdominal pain, and evolving skin ulcers. Initial evaluation revealed elevated white-cell count, uterine tenderness, and purulent inguinal pustules. Imaging demonstrated ascites, anasarca, hepatosplenomegaly, and intrahepatic fluid collections. Biopsies ruled out infection but showed dense neutrophilic inflammation. Skin lesions exhibited pathergy at catheter sites, progressing to necrotic ulcers. Cultures were sterile despite broad-spectrum antibiotics. Diagnostic workup pointed to systemic Sweet’s syndrome, a pregnancy-associated neutrophilic dermatosis with extracutaneous involvement. Skin biopsy confirmed neutrophilic infiltrate without vasculitis. Treatment with systemic glucocorticoids resulted in rapid resolution of symptoms and ulcer healing. The patient and her infant both recovered well.

This case concerns a 30-year-old woman, six days postpartum, presenting with fever, abdominal pain, and evolving skin ulcers. Initial evaluation revealed elevated white-cell count, uterine tenderness, and purulent inguinal pustules. Imaging demonstrated ascites, anasarca, hepatosplenomegaly, and intrahepatic fluid collections. Biopsies ruled out infection but showed dense neutrophilic inflammation. Skin lesions exhibited pathergy at catheter sites, progressing to necrotic ulcers. Cultures were sterile despite broad-spectrum antibiotics. Diagnostic workup pointed to systemic Sweet’s syndrome, a pregnancy-associated neutrophilic dermatosis with extracutaneous involvement. Skin biopsy confirmed neutrophilic infiltrate without vasculitis. Treatment with systemic glucocorticoids resulted in rapid resolution of symptoms and ulcer healing. The patient and her infant both recovered well.