scholarly journals Profile And Treatment Steven Johnson Syndrome Patients In Inpatient Kemuning I And II RSUD DR. Soetomo Period 2011-2015

2019 ◽  
Vol 4 (2) ◽  
pp. 32
Author(s):  
Anggun Tera Rahmasari
Keyword(s):  
Medical Records ◽  
Secondary Data ◽  
Clinical History ◽  
Duration Of Treatment ◽  
Johnson Syndrome ◽  
Systemic Treatments ◽  
Life Threatening ◽  
History Of ◽  
Medical Histories ◽  
Steven Johnson Syndrome

Background: Steven Johnson Syndrome (SJS) is uncommon but potentially life threatening disease. SJS is Severe Cutaneous Adverse Reaction (SCAR). SJS is mostly caused by drugs and related with morbidity and mortality. Some researches have been published, but there was no standard for SJS’ treatment. The aim of this study is to present epidemiological features, aetiologies, clinical outcomes, medical histories, and treatments of SJS in Inpatient Unit Kemuning I and II RSUD Dr. Soetomo 2011-2015.Methods: This research used retrospective study which use secondary data collected from medical records. All of patients in Inpatient Kemuning I and II RSUD Dr. Soetomo from year 2011-2015 who diagnosed SJS were included in this research.Result: There were 29 medical records and consist of 23 woman and 6 man with the diagnosis of SJS found in 2011-2015. Most patients aged 25-44 years old. Most clinical history was fever. Drug which is expected to be the most cause of SJS is amoxicillin. There was no family history of SJS in all patients. Mucosa that was involved the most was eyes and mouth. Systemic treatments for patients were corticosteroid. The average duration of treatment was 15,88 day. None of the patients died.Conclusion: Females were more than males. The main systemic therapy in Inpatient Kemuning I dan II RSUD Dr. Soetomo is intravenous cortiosteroid and no patients died.

scholarly journals Cutaneous Adverse Drug reactions: A Four-Year Study from Western Nepal

2018 ◽  
Vol 10 (2) ◽  
pp. 21-26 ◽  
Author(s):  
S Neupane ◽  
B Basnet
Keyword(s):  
Adverse Drug Reactions ◽  
College Teaching ◽  
Clinical History ◽  
Stevens Johnson Syndrome ◽  
Drug Reactions ◽  
Medical College ◽  
Johnson Syndrome ◽  
Detailed Clinical History ◽  
Life Threatening ◽  
History Of

Background: Cutaneous adverse drug reactions (CADRs) range from minor reactions to several life threatening complications. Objectives: To study the clinical spectrum of cutaneous adverse drug reactions, determine the causative drugs responsible for the reactions and to assess the preventability.Methods: The study was carried out in the Department of Dermatology of Gandaki Medical College Teaching Hospital from June 2011 to June 2015. All the patients attending the Dermatology Outpatient Department and the patients admitted in the wards with suspected cutaneous adverse drug reactions to systemic drugs were included in the study. A detailed clinical history, including the history of drug intake was noted. Each case was assessed for its causality by using the WHO definitions. Data analysis was done using SPSS software.Results: There were 102 patients in total. The mean age of the patient was 32 ±15.7 years. Maximum patients belonged to the 21 to 30 years age group. There were 59 female patients and 43 male patients. Severe type of cutaneous adverse drug reactions was noted in 7.8% of patients. Antibiotics were responsible for most of the cutaneous adverse drug reactions. Cefixime was the most commonly incriminated drug. Exanthematous drug reaction was the most common type seen in 45%. Stevens-Johnson syndrome was the commonest type noted among the serious adverse drug reactions. Drug preventability was noted in 6% of patients.Conclusions: The commonest type of CADR noted was exanthematous type. Antibiotics were the commonest drug group involved in CADR. Six percent of CADR were preventable. J-GMC-N | Volume 11 | Issue 01 | January-June 2018, Page: 21-26

scholarly journals Stevens-Johnson Syndrome in a Child on Phenytoin, Exacerbated with Cefixime

2019 ◽  
Vol 39 (3) ◽  
pp. 193-196 ◽  
Author(s):  
Yam Bahadur Roka ◽  
Sabrina Shrestha ◽  
Narayani Roka ◽  
Mohan Karki
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Whole Body ◽  
Stevens Johnson Syndrome ◽  
Intravenous Fluids ◽  
Oral Ulceration ◽  
Topical Antibiotics ◽  
Johnson Syndrome ◽  
Life Threatening ◽  
History Of ◽  
Steven Johnson Syndrome

Steven Johnson syndrome and toxic epidermal necrolysis are rare but potentially life threatening muco-cutaneous disorders. Their incidence ranges from 1.2 to six per million patient-years for Steven Johnson syndrome and 0.4 to 1.2 per million patient-years for toxic epidermal necrolysis. Drugs are the primary cause for these syndromes in majority cases. They might also be due to infections with Mycoplasma Pneumoniae or Herpes Simplex. The mortality ranges from five to 40% in these cases. We report a 10-year old girl who presented with history of multiple skin eruptions involving whole body and oral ulceration for five days. She was a known case of seizure disorder on phenytoin and had been prescribed Cefexime for fever. She was managed with intravenous fluids, corticosteroids, opiates, antacids and topical antibiotics. We want to highlight the possibility of Steven Johnson syndrome following the combination of these two drugs.

scholarly journals Steven johnson syndrome induce by carbamazepine in epileptic patient: a case report

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Nyoman Yoga Maya Pramita ◽  
Prima Saraswati Sanjiwani Sudarsa ◽  
Ratih Purnamasari Nukana
Keyword(s):  
Epileptic Patient ◽  
Case Series ◽  
Johnson Syndrome ◽  
Chief Complaints ◽  
Upper And Lower Extremities ◽  
Life Threatening ◽  
History Of ◽  
Appropriate Therapy ◽  
Steven Johnson Syndrome

Introduction: Steven Johnson Syndrome (SJS) is life-threatening skin reaction, it is a mucocutaneous disorder induced by immune complex-mediated hypersensitivity reaction. Most frequent offending agents are antibiotic, antiretroviral and aromatic anticonvulsants. Problems arise when these drugs are required for long-term use and necessary for several health conditions. These case series aim to describe SJS and provide replacement therapy especially inpatient with epilepsy.Case report: A 37 years old female was consulted from neurology department with chief complaints an erythematous rash on her chest, back upper and lower extremities accompanied with fever, the patient also complaint erosions on her lips. She had history of seizure and was prescribe Carbamazepine. Carbamazepine was replaced and patient treated with dexamethasone intravenously. After 1 week of admitted there is an improvement.Conclusion: Steven Johnson Syndrome (SJS) is a life-threatening disease, the replacement of the suspected drugs and appropriate therapy can improve the prognosis of patient. 

scholarly journals Anaphylactic Death: A New Forensic Workflow for Diagnosis

Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 117
Author(s):  
Massimiliano Esposito ◽  
Angelo Montana ◽  
Aldo Liberto ◽  
Veronica Filetti ◽  
Nunzio Di Nunno ◽  
...  
Keyword(s):  
Clinical History ◽  
Rapid Onset ◽  
Mean Value ◽  
Laryngeal Edema ◽  
Tryptase Level ◽  
Antibody Staining ◽  
Life Threatening ◽  
History Of ◽  
Immunohistochemical Techniques

Anaphylaxis is a life-threatening or fatal clinical emergency characterized by rapid onset, and death may be sudden. The margin of certainty about the diagnosis of anaphylactic death is not well established. The application of immunohistochemical techniques combined with the evaluation of blood tryptase concentrations opened up a new field of investigation into anaphylactic death. The present study investigated eleven autopsy cases of anaphylactic death, carried out between 2005 and 2017, by the Departments of Forensic Pathology of the Universities of Foggia and Catania (Italy). An analysis of the medical records was carried out in all autopsies. Seven autopsies were carried out on males and four on females. Of the eleven cases, one showed a history of asthma, one of food ingestion, two of oral administration of medications, six did not refer any allergy history, and one subject was unknown. All cases (100%) showed pulmonary congestion and edema; 7/11 (64%) of the cases had pharyngeal/laryngeal edema and mucus plugging in the airway; only one case (9%) had a skin reaction that was found during external examination. Serum tryptase concentration was measured in ten cases, and the mean value was 133.5 µg/L ± 177.9. The immunohistochemical examination using an anti-tryptase antibody on samples from the lungs, pharynx/larynx, and skin site of medication injection showed that all cases (100%) were strongly immunopositive for anti-tryptase antibody staining on lung samples; three cases (30%) were strongly immunopositive for anti-tryptase antibody staining on pharyngeal/laryngeal samples; and eight cases (80%) were strongly immunopositive for anti-tryptase antibody staining on skin samples. We conclude that a typical clinical history, blood tryptase level >40 µg/L, and strongly positive anti-tryptase antibody staining in the immunohistochemical investigation may represent reliable parameters in the determination of anaphylactic death with the accuracy needed for forensic purposes.

scholarly journals Gambaran Kasus Difteri Tahun 2009-Agustus 2019 di Kabupaten Bojonegoro

2020 ◽  
Vol 8 (2) ◽  
pp. 67
Author(s):  
Kiki Famalasari
Keyword(s):  
Secondary Data ◽  
Distribution Patterns ◽  
Surveillance Program ◽  
Age Group ◽  
District Health Office ◽  
District Health ◽  
Work Area ◽  
Serious Infections ◽  
Life Threatening ◽  
History Of

Pendahuluan : Difteri adalah suatu infeksi yang disebabkan oleh bakteri Corybacterium diphteriae, yang menyerang selaput lendir pada hidung dan tenggorokan, serta dapat mempengaruhi kulit. Penyakit ini sangat menular dan termasuk infeksi serius yang berpotensi mengancam jiwa.Tujuan : Penelitian ini bertujuan untuk menganalisis pola distribusi kasus difteri di Kabupaten Bojonegoro pada tahun 2009– 2019 (Agustus 2019).Metode : Penelitian ini dilakukan pada tanggal l5 Agustus-18 September 2019 di Kabupaten Bojonegoro. Penelitian ini adalah penelitian deskriptif dengan menggunakan data sekunder berupa laporan bulanan kasus difteri yang dilaporkan oleh Puskesmas atau Rumah Sakit di Wilayah kerja Dinas Kesehatan Kabupaten Bojonegoro dan hasil wawancara dengan Kepala Seksi Surveilans dan Imunisasi, serta Penanggungjawab Program Surveilans Difteri di Dinas Kesehatan Kabupaten Bojonegoro.Hasil : Hasil penelitian menunjukkan bahwa berdasarkan usia kasus difteri di Kabupaten Bojonegoro tertinggi terjadi pada kelompok usia 5-9 tahun (29,16%). Berdasarkan jenis kelamin sebagian besar terjadi pada jenis kelamin laki-laki (61,84%). Berdasarkan status imunisasi, kejadian difteri terjadi pada kelompok usia < 1tahun. Berdasarkan tempat, kejadian difteri di Kabupaten Bojonegoro sering terjadi di Kecamatan Bojonegoro. Berdasarkan waktu, kejadian difteri terjadi pada periode Januari-Maret dan Agustus-Desember.Kesimpulan : Kasus penyakit difteri di Kabupaten Bojonegoro dari tahun 2009 sampai dengan Agustus 2019 cenderung fluktuatif. Pada tahun 2009 hingga tahun 2012 kasus difteri di Kabupaten Bojonegoro mengalami peningkatan yang signifikan dan mengalami penurunan di tahun 2013 dan 2014. Kemudian pada tahun 2015, kasus difteri mengalami peningkatan kembali dan penemuan kasus terbanyak ada di tahun 2018 yaitu sebanyak 15 kasus.Penderita difteri paling banyak adalah anak usia 5-9 tahun yaitu sebanyak 21 anak. Beberapa penderita difteri memiliki riwayat imunisasi yang tidak lengkat maupun yang tidak pernah imunisasi sama sekali. Sedangkan penemuan kasus difteri terbanyak sering terjadi pada laki-laki.ABSTRACTBackground: Diphtheria is an infection caused by the Bacterium Corybacterium diphteriae, which attacks the mucous membranes of the nose and throat,then can affect the skin. This disease is very contagious and includes serious infections that are potentially life-threatening. Objectives: This study to analyze the distribution patterns of diphtheria cases in Bojonegoro Regency in 2009 - 2019 (August 2019). Methods This research was conducted on August 5-September 18, 2019 in Bojonegoro Regency. This research is a descriptive study using secondary data in the form of monthly reports of diphtheria cases reported by Puskesmas or Hospitals in the Work Area of the Bojonegoro District Health Office and the results of interviews with the Head of the Surveillance and Immunization Section, and the Person in Charge of the Diphtheria Surveillance Program at the Bojonegoro District Health Office. Result: The results showed that the highest age of diphtheria cases in Bojonegoro District occurred in the 5-9 years age group (29.16%). Based on sex, the majority occurred in male sex (61.84%). Based on immunization status, the incidence of diphtheria occurs in the age group <1 year. Based on location, diphtheria events in Bojonegoro Regency often occur in Bojonegoro District. By time, diphtheria events occurred in the January-March and August-December periods. Conclusions: Cases of diphtheria in Bojonegoro Regency from 2009 to August 2019 tended to be volatile. In 2009 until 2012 diphtheria cases in Bojonegoro Regency experienced a significant increase and decreased in 2013 and 2014. Then in 2015, diphtheria cases increased again and the most cases found were in 2018 which were 15 cases. The most diphtheria sufferers many are children aged 5-9 years, as many as 21 children. Some diphtheria sufferers have a history of immunizations that are not complete or have never been immunized at all. Whereas most cases of diphtheria are often found in men.

scholarly journals Meropenem-induced Stevens-Johnson syndrome/toxic epidermal necrolysis in a patient with known type IV penicillin hypersensitivity

2019 ◽  
Vol 12 (8) ◽  
pp. e230144 ◽  
Author(s):  
Muhammad Sameed ◽  
Christine Nwaiser ◽  
Prashant Bhandari ◽  
Sarah A Schmalzle
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Cross Reactivity ◽  
Delayed Hypersensitivity ◽  
Stevens Johnson Syndrome ◽  
Hypersensitivity Reactions ◽  
Beta Lactam ◽  
Type Iv ◽  
Johnson Syndrome ◽  
Life Threatening ◽  
History Of

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are considered variants of a disease continuum that results in a life-threatening exfoliative mucocutaneous disease. These are categorised as type IV cell-mediated delayed hypersensitivity reactions, and antibiotics are often implicated as a cause. Penicillins and other beta-lactam antibiotics are known to cause both immediate and delayed hypersensitivity reactions. While immediate IgE-mediated cross-reactivity between penicillins and carbapenems is well studied, less information on the risk of type IV delayed cell-mediated cross-reactivity between the two is available. We present a case of meropenem-induced SJS in a patient with documented history of SJS from amoxicillin. There are few cases of cross-reactivity with carbapenems reported in the literature, but based on the potential for life-threatening reaction, it is likely prudent to avoid the use of any beta-lactams in a patient with a history of SJS, TEN or any other severe cutaneous adverse reactions to another beta-lactam antibiotic.

The Neat-HER Virtual Registry: A novel registry following HER2+ ESBC patients receiving neratinib in the extended adjuvant setting.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12035-e12035 ◽  
Author(s):  
Debu Tripathy ◽  
Gregory A. Vidal ◽  
Deepa Lalla ◽  
Richard Bryce ◽  
Gillian Hanson ◽  
...  
Keyword(s):  
Real World ◽  
Medical Records ◽  
Clinical History ◽  
The United States ◽  
World Population ◽  
Duration Of Treatment ◽  
Cancer History ◽  
Data Points ◽  
Research Questions ◽  
Study Sites

e12035 Background: While data from traditional registries are limited to patients (pts) treated at study sites, virtual registries can enroll a more diverse real-world population. Neat-HER is a US-based, non-interventional pilot virtual registry through PicnicHealth that will enroll 100 pts with HER2+ BC receiving neratinib as extended adjuvant therapy. Methods: Neat-HER will evaluate the feasibility of enrolling pts & answering research questions using this novel methodology. Eligibility includes receipt of neratinib, signed informed consent for medical record retrieval/data abstraction & > 18 years age at study consent. Pts who fail to complete enrollment procedures, are participating in a clinical trial, have metastatic disease, or who lack adequate medical records will be excluded. For each pt discontinuing neratinib within 60 days of starting treatment, an additional pt will be recruited, but all pts will be included in the analysis. Pts are recruited through multiple mechanisms incl. private social media groups, treating clinicians & pts enrolled in the Puma texting program. PicnicHealth will collect & structure medical records from medical practices in the United States for ~7 years prior to enrolment up to 1 year after enrolment. Research questions focus on descriptive pt characteristics & demographics, breast cancer history [(neo)adjuvant treatment/outcomes], use of diarrhea prophylaxis, incidence of diarrhea & duration of neratinib. Results: Enrollment began in 12/2018 with target completion in 4/2019. As of 2/2019, 42 pts have initiated enrolment. Of these, 19 pts completed enrolment & 69,750 data points have been extracted from medical records. Descriptive statistics will be used to characterize the pt cohort. Duration of treatment, receipt & type of prophylaxis, incidence of diarrhea, treatment discontinuation & reasons for discontinuation will be summarized for all pts. Conclusions: A virtual registry allows assessment of medication use & outcomes in a diverse population in a rapid timeframe. Neat-HER will provide comprehensive information on clinical history & treatment patterns in a real-world cohort of pts receiving extended adjuvant neratinib.

scholarly journals The utility of the records medical: factors associated with the medication errors in chronic disease

2017 ◽  
Vol 25 (0) ◽  
Author(s):  
Hellen Lilliane da Cruz ◽  
Flávia Karla da Cruz Mota ◽  
Lorena Ulhôa Araújo ◽  
Emerson Cotta Bodevan ◽  
Sérgio Ricardo Stuckert Seixas ◽  
...  
Keyword(s):  
Chronic Diseases ◽  
Medication Errors ◽  
Medical Records ◽  
Secondary Data ◽  
Diabetic Patients ◽  
Medication History ◽  
Factors Associated ◽  
Compromise Patient Safety ◽  
History Of ◽  
The Mean

ABSTRACT Objective: This study describes the development of the medication history of the medical records to measure factors associated with medication errors among chronic diseases patients in Diamantina, Minas Gerais. Methods: retrospective, descriptive observational study of secondary data, through the review of medical records of hypertensive and diabetic patients, from March to October 2016. Results: The patients the mean age of patient was 62.1 ± 14.3 years. The number of basic nursing care (95.5%) prevailed and physician consultations were 82.6%. Polypharmacy was recorded in 54% of sample, and review of the medication lists by a pharmacist revealed that 67.0% drug included at least one risk. The most common risks were: drug-drug interaction (57.8%), renal risk (29.8%), risk of falling (12.9%) and duplicate therapies (11.9%). Factors associated with medications errors history were chronic diseases and polypharmacy, that persisted in multivariate analysis, with adjusted RP chronic diseases, diabetes RP 1.55 (95%IC 1.04-1.94), diabetes/hypertension RP 1.6 (95%CI 1.09-1.23) and polypharmacy RP 1.61 (95%IC 1.41-1.85), respectively. Conclusion: Medication errors are known to compromise patient safety. This has led to the suggestion that medication reconciliation an entry point into the systems health, ongoing care coordination and a person focused approach for people and their families.

scholarly journals A Case Report of Steven Johnson Syndrome

2021 ◽  
pp. 132-139
Author(s):  
Archana Dhengare ◽  
Ranjana Sharma ◽  
Sonali Waware ◽  
Pranali Wagh
Keyword(s):  
Stevens Johnson Syndrome ◽  
Skin Allograft ◽  
Case Presentation ◽  
Johnson Syndrome ◽  
Chief Complaints ◽  
Long Time ◽  
History Of ◽  
Long Term Consequences ◽  
Steven Johnson Syndrome

Introduction: In 1922, two doctors, Albert Mason Stevens and Frank Johnson, examined purulent conjunctivitis.” Background: Stevens-Johnson syndrome was named after them as a result of their study. The incidence rate is 7 cases per million populations per year. Case Presentation: Master Yash Ghudam was brought to AVBRH by his parents with chief complaints of fever since 5 days and erythematous lesions all over body since 3 days. History of present illness: Patient was apparently alright 5 days back, and then he started having fever which was of high grade and was not associated with chills and rigor. Patient was treated on OPD basis and the symptoms of an unexplained disease in two young boys, aged 7 and 8, who had "an unusual, generalised eruption of continued fever, inflamed buccal mucosa, and extreme some antibiotic was given, but there was no relief, after 2 days there was ulcers formation inside the mouth for which some ointment and syrup becosule was started. But lesions were increasing. 3 days back the lesions first appeared on chest then got spread to legs and hands. For which patient was admitted in Chandrapur hospital from were the patient was referred to AVBRH for further management. Interventions: The patient was treated the patient was started on intravenous and orally Cortecosteroids, Omnacortil 10mg, Antibiotics- Inj. Ceftriaxone1gm IV 12 hourly [100mg/kg/day], inj. Amikacin 150mg IV 12 hourly [15mg/kg/day], Syp. Mucaine gel 2tsp BD – swish and swallow), Syp. Cital  2.5ml TDS, Tab. Chymoral Forte  TDS, Inj. Pantop 20mg IV 24 hourly (1mg/kg/dose). Pandya’s Formula: Syp. Gelusil 5ml, Syp. Benadryl 5ml, Syp. Omnacortil 5ml.  Skin allograft: It has been planned. Conclusion: In this study, we mainly focus on medical management and outstanding nursing care helped prevent farther complication. Overall, the patient's reaction was positive, though recovery time from Steven johnson syndrome varies from person to person, taking weeks, months, or even years. However, only a small number of people completely recover, while some have long-term consequences. She took a long time to get back on her feet.

scholarly journals Phenytoin induced toxic epidermal necrolysis: a case report

2019 ◽  
Vol 8 (6) ◽  
pp. 1448
Author(s):  
Sandipan Barkakaty ◽  
Girish K.
Keyword(s):  
Oral Cavity ◽  
Toxic Epidermal Necrolysis ◽  
Past History ◽  
Clinical History ◽  
The Body ◽  
Stevens Johnson Syndrome ◽  
Medicine Department ◽  
Johnson Syndrome ◽  
History Of ◽  
Emergency Medicine Department

Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), are severe idiosyncratic reactions characterized by fever and mucocutaneous lesions leading to necrosis and sloughing of the epidermis. The usage of anticonvulsants like carbamazepine, phenytoin, lamotrigine, phenobarbital are associated with high risk for occurrence of TEN. We present a case of toxic epidermal necrolysis in a 30 year old female probably induced by phenytoin. A 30 year old female was admitted to the emergency medicine department of KIMS hospital, Bengaluru. Lesions over the lips and oral cavity, multiple fluid filled blisters were present diffusely all over the body. Patient had a past history of oral cavity lesions with injection phenytoin. Patient is a known epileptic of over 12 years and was on treatment. Patient had a seizure attack 3 days back and visited nearby hospital and did not inform the doctor of her allergy to phenytoin. Patient was given inj phenytoin after which she developed oral lesions and also presented with fluid filled bullae all over the body. A diagnosis of toxic epidermal necrolysis was made based on clinical history and Scoreten score and was treated with betadine wash, fluconazole and antibiotics .The lesions improved significantly with the above management and patient recovered enough to be discharged from the hospital after 5 days. Severe and serious reactions such as toxic epidermal necrolysis can be caused by commonly used drugs like phenytoin.

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