Rifampicin-Associated Sweet Syndrome: An Uncommon Adverse Event of Anti-Tuberculosis Therapy.

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.