Ertapenem rescue therapy in hidradenitis suppurativa.
JAAD Case Rep
Hidradenitis suppurativa (HS) is a chronic, inflammatory, follicular disorder which presents with significant treatment challenges, largely in part because the pathogenesis is not well understood. While there are many new and emerging therapies, HS flares often remain difficult to control, and concerns of infection throughout the disease course remain prominent. Ertapenem use in HS represents a novel therapy. A recent study found significant improvement in pain and drainage of HS lesions following six weeks of daily intravenous (IV) infusion through a peripherally inserted central catheter. The authors demonstrated the role of ertapenem as an effective means to reduce bacterial load and bridge patients to definitive surgical therapy. We describe a case involving a 21-year-old man with history of Hurley stage III HS who, while on infliximab therapy, was hospitalized for fever and leukocytosis. Despite negative blood, urine, and tissue cultures, concerns for sepsis were present, and the patient was placed on IV ertapenem. Three days later, the patient’s fever subsided and he was instructed to continue ertapenem as an outpatient via a PICC line for six weeks total. Following completion of treatment, the patient reported decreased pain and drainage of HS lesions with no fever recurrence. This case demonstrates ertapenem as a promising rescue treatment for HS patients with concern for sepsis, without another identifiable source.