Phenytoin Induced Stevens Johnson Syndrome- Toxic Epidermal Necrolysis Overlap Exacerbated by Cephalexin in a 65-Year-Old Neurosurgical Patient: A Rare Case Report

2021 ◽  
Vol 13 ◽  
Author(s):  
Kiran Kumar Rathinam ◽  
Sarvesh Sabarathinam ◽  
Poojith Nuthalapati ◽  
Vijayakumar Thangavel Mahalingam
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Detailed Examination ◽  
The Body ◽  
Stevens Johnson Syndrome ◽  
Communicating Hydrocephalus ◽  
Drug Induced ◽  
Johnson Syndrome ◽  
Rare Case Report ◽  
Epidermal Necrosis

Objective: To report a rare case of drug induced overlap of Stevens-Johnson syndrome and Toxic Epidermal Necrosis Syndrome exacerbated by cephalexin. Case summary: In this case report we present a 65-year-old female who had come to the hospital with complaints of Sloughing of the skin and redness all over the body with raised body temperature. She was on therapeutic Phenytoin to prevent the post-surgical complications of Communicating Hydrocephalus. After a detailed examination it was found that the patient had misemployed with an overdose of Phenytoin. The patient was found with nikolsky sign and diagnosed as Stevens-Johnson syndrome and Toxic Epidermal Necrosis overlap. This case report emphasizes phenytoin induced Stevens-Johnson syndrome and Toxic Epidermal Necrosis syndrome exacerbated by cephalexin. Practice implications: By witnessing this phenomenon, we could figure out the association between cephalexin and Stevens-Johnson syndrome- Toxic Epidermal Necrosis syndrome overlap. The Immediate dismissal of the offending agent and commencement of supportive care was found to be effective.

scholarly journals ACECLOFENAC INDUCED STEVENS JOHNSON SYNDROME: A RARE CASE REPORT

2017 ◽  
Vol 4 (1) ◽  
pp. 76-79
Author(s):  
R Hasan ◽  
◽  
A Abidi ◽  
A Ahmad ◽  
K Saxena ◽  
...  
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome ◽  
Rare Case Report

scholarly journals METHOTREXATE INDUCED STEVENS JOHNSON SYNDROME: A RARE CASE REPORT

2018 ◽  
Vol 5 (2) ◽  
pp. 197-199
Author(s):  
Surabhi Arora ◽  
Afroz Abidi ◽  
Fariha Fatima ◽  
Roohana Hasan ◽  
Darakhshan Rizvi ◽  
...  
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome ◽  
Rare Case Report

Tenofovir-induced Stevens-Johnson syndrome in a patient with acute hepatitis B: A rare case report

2020 ◽  
Vol 60 (6) ◽  
pp. e365-e369 ◽  
Author(s):  
Saju Xavier ◽  
Athira P ◽  
Abel C. Mathew ◽  
Hathim Basheer ◽  
Rahana K ◽  
...  
Keyword(s):  
Case Report ◽  
Hepatitis B ◽  
Acute Hepatitis ◽  
Rare Case ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome ◽  
Acute Hepatitis B ◽  
Rare Case Report

Linezolid Induced Skin Reactions in a Multi Drug Resistant Infective Endocarditis Patient: A Rare Case

2020 ◽  
Vol 15 (3) ◽  
pp. 222-226 ◽  
Author(s):  
Asha K. Rajan ◽  
Ananth Kashyap ◽  
Manik Chhabra ◽  
Muhammed Rashid
Keyword(s):  
Case Report ◽  
Infective Endocarditis ◽  
Rare Case ◽  
Case Reports ◽  
Multidrug Resistant ◽  
The Body ◽  
Prior History ◽  
Skin Reactions ◽  
Rare Case Report ◽  
Multiple Drugs

Rationale: Linezolid (LNZ) induced Cutaneous Adverse Drug Reactions (CADRs) have rare atypical presentation. Till date, there are very few published case reports on LNZ induced CADRs among the multidrug-resistant patients suffering from Infective Endocarditis (MDR IE). Here, we present a rare case report of LNZ induced CARs in a MDR IE patient. Case report: A 24-year-old female patient was admitted to the hospital with chief complaints of fever (101°C) associated with rigors, chills, and shortness of breath (grade IV) for the past 4 days. She was diagnosed with MDR IE, having a prior history of rheumatic heart disease. She was prescribed LNZ 600mg IV BD for MDR IE, against Staphylococcus coagulase-negative. The patient experienced flares of cutaneous reactions with multiple hyper-pigmented maculopapular lesions all over the body after one week of LNZ therapy. Upon causality assessment, she was found to be suffering from LNZ induced CADRs. LNZ dose was tapered gradually and discontinued. The patient was prescribed corticosteroids along with other supportive care. Her reactions completely subsided and infection got controlled following 1 month of therapy. Conclusion: Healthcare professionals should be vigilant for rare CADRs, while monitoring the patients on LNZ therapy especially in MDR patients as they are exposed to multiple drugs. Moreover, strengthened spontaneous reporting is required for better quantification.

scholarly journals ORAL SECONDARY INFECTION IN STEVENS-JOHNSON SYNDROME PATIENT WITH ORAL INVOLVEMENT: A CASE REPORT

2021 ◽  
Vol 6 (1) ◽  
pp. 79
Author(s):  
Etis Duhita Rahayuningtyas ◽  
Indah Suasani Wahyuni ◽  
Irna Sufiawati
Keyword(s):  
Case Report ◽  
Secondary Infection ◽  
Severity Of Illness ◽  
The Body ◽  
Stevens Johnson Syndrome ◽  
High Dose ◽  
Oral Manifestation ◽  
Secondary Infections ◽  
Johnson Syndrome ◽  
Oral Involvement

ABSTRACTBackground: Stevens-Johnson syndrome (SSJ) is a hypersensitivity reaction that is often triggered by drugs but this case is rare. These reactions result in uncontrolled keratinocyte damage to the skin and mucosa throughout the body, including the oral mucosa, and are often life-threatening. The use of high doses of corticosteroids is a treatment that is often given but it can trigger secondary infections of fungal and viral in the oral cavity. Purpose: This case report discusses the management of oral manifestations and secondary infections in SSJ patients, and becomes guidance for health professionals. Case: A-42-years-old male patient was consulted from the Department of Dermatology and Venereology (DV) due to oral pain and eating difficulties. The severity-of-illness-score for toxic-epidermal-necrolysis (SCORTEN) was 1. Erosive serosanguinous crusts, tend to bleed were found on the lips. Intraoral clinically presented wide erosive lesions and multiple ulcers, accompanied by a pseudomembranous plaque, and teeth decay. Hematologic examination showed an increase in leukocytes, neutrophil segments, monocytes, SGOT, urea, and creatinine as well as decreased hemoglobin, hematocrit, erythrocytes, MCHC, protein, and albumin. Anti-HSV1 IgG increased almost 6 times than normal values. The patient was diagnosed with SJS with oral involvement, secondary infections of pseudomembranous candidiasis, and herpetic stomatitis. Case Management: Systemic therapy given were intravenous dexamethasone, ranitidine, calcium, and cetirizine, from the DV Department, while hydrocortisone lip ointment, Chlorhexidine digluconate 0.12%, and Nystatin oral suspension for oral problems. The lesions progressed in 24 days. Conclusion: Oral secondary infections may occur in SJS patients due to high-dose corticosteroid therapy.Keywords: Herpetic Stomatitis, Oral Manifestation, Oral Secondary Infection, Pseudomembranous Candidiasis, Stevens-Johnson Syndrome.

scholarly journals Stevens–Johnson syndrome and acute vanishing bile duct syndrome after the use of amoxicillin and naproxen in a child

2019 ◽  
Vol 47 (9) ◽  
pp. 4537-4543 ◽  
Author(s):  
Lu Li ◽  
Sujun Zheng ◽  
Yu Chen
Keyword(s):  
Case Report ◽  
Bile Duct ◽  
Epithelial Cells ◽  
Hypersensitivity Reaction ◽  
Stevens Johnson Syndrome ◽  
Drug Induced ◽  
Vanishing Bile Duct Syndrome ◽  
Johnson Syndrome ◽  
Vanishing Bile Duct ◽  
Duct Syndrome

We present the case report of a 6-year-old patient who developed Stevens–Johnson syndrome (SJS) and acute vanishing bile duct syndrome (VBDS) after taking oral amoxicillin and naproxen. SJS, an immune complex-mediated hypersensitivity reaction involving the skin and mucosa, is usually drug-induced, and it can lead to systemic symptoms. Acute VBDS is rare, often presenting with progressive loss of the intrahepatic biliary tract. VBDS is an immune-mediated bile duct-associated disease, and immunological damage to the bile duct system is an important mechanism for VBDS. Serious drug-induced liver injury (DILI) is also associated with immunity. The drug acts as a hapten with keratin on the surface of biliary epithelial cells. The autoantibodies produced by this action can damage the bile duct epithelial cells and cause the bile duct to disappear. SJS is a serious type of polymorphic erythema that is mainly considered to be a hypersensitivity reaction to drugs, and it may involve multiple factors.  The patient in this case report was treated with glucocorticoids, plasma exchange, ursodeoxycholic acid, and traditional Chinese medicine. He recovered completely within 5 months. This case report indicates that caution should be used because amoxicillin and naproxen can cause SJS and VBDS in children.

Drug Induced-Stevens Johnson Syndrome: A Case Report

2016 ◽  
Vol 2 (4) ◽  
pp. 144-145
Author(s):  
Neethu George ◽  
Persis Johnson ◽  
Jisna Thomas ◽  
Aloshin Mariya
Keyword(s):  
Case Report ◽  
Stevens Johnson Syndrome ◽  
Drug Induced ◽  
Johnson Syndrome
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