scholarly journals Rifampicin- and allopurinol-induced Stevens-Johnson syndrome: A case series

2021 ◽  
Vol 65 ◽  
pp. 51-54
Author(s):  
Bhavana Srivastava ◽  
Reena Bhardwaj ◽  
Renu Khanchandani ◽  
Zafar Masood Ansari ◽  
Gunjita Belwal
Keyword(s):  
Adverse Effects ◽  
Pulmonary Tuberculosis ◽  
Causality Assessment ◽  
Case Series ◽  
Young Male ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome ◽  
Mucous Membranes ◽  
Life Threatening ◽  
Severe Skin Reaction

Stevens-Johnson syndrome (SJS) is a rare, serious disorder and may be life threatening affecting mainly mucocutaneous tissues. It is a type of generalised, multisystemic hypersensitivity reaction directly linked to the drug intake. It is one of the few serious adverse effects of drugs involving skin and mucous membranes which are characterised by rash, bullae and blisters spread on skin, mucous membranes, swelling with erosive lesions on lips and face and hyperpigmentation. Normally, SJS is a self-resolving condition but it has potential to be converted into life-threatening disease. Here, we describe and present a case series of SJS inflicted by rifampicin and allopurinol. First one is a 28-year-old-female and second case is a 50-year-old male, both received rifampicin for pulmonary tuberculosis. Third patient is a 22-year-old young male taken allopurinol for hyperuricemia. All these patients noticed a severe skin reaction which is a part of erythema multiforme spectrum. Causality assessment was done in these patients with the help of Naranjo’s algorithm and diagnosed as cases of SJS.

STEVENS-JOHNSON SYNDROME DUE TO ADVERSE DRUG REACTIONS: A CASE SERIES

2021 ◽  
pp. 1-3
Author(s):  
ZAFAR MASOOD ANSARI ◽  
BHAVANA SRIVASTAVA ◽  
ARUNIMA ROHATGI
Keyword(s):  
Clinical Practice ◽  
Adverse Effects ◽  
Case Series ◽  
Stevens Johnson Syndrome ◽  
Drug Reactions ◽  
Extreme Caution ◽  
First Case ◽  
Johnson Syndrome ◽  
Mucous Membranes ◽  
Severe Skin Reaction

Stevens-Johnson syndrome (SJS) is a rare, serious disorder affecting skin and mucous membranes. It is one of the few serious dermatological adverse effects of drugs encountered in clinical practice which is characterized by blisters and rash on skin, mucous membranes, swelling over face and lips, and hyperpigmentation. After that, the outer layer of affected skin becomes dead, sheds, and starts to heal after several days of inflicting injury. Here, we present a case series of ofloxacin and chloroquine induced SJS after the consent given by patients. First case is a 62 years old male received Ofloxacin and second patient is a 40 years old male received chloroquine. Both patients experienced a severe skin reaction which was diagnosed as SJS. The above-mentioned medications will be implicated in cases of SJS. We should prescribe these medications with extreme caution.

scholarly journals Allopurinol Induced Stevens-Johnson Syndrome

2021 ◽  
Vol 12 (1) ◽  
pp. 829-831
Author(s):  
Athul Gopan ◽  
Anukrishna V P ◽  
Devina Janeendran ◽  
Athulya Subhash ◽  
Jacob Thomas ◽  
...  
Keyword(s):  
Health Care ◽  
Adverse Effects ◽  
Health Care Professionals ◽  
Rare Case ◽  
Oxidase Inhibitor ◽  
Stevens Johnson Syndrome ◽  
Xanthine Oxidase Inhibitor ◽  
Normal Limits ◽  
Johnson Syndrome ◽  
Life Threatening

Stevens-Johnson Syndrome (SJS) is an acute, self-limited, rare but life-threatening disease that manifests as severe mucocutaneous blistering and erosions. Here we report a rare case of allopurinol-induced SJS. A 25-year-old male patient with no other comorbidities was admitted to the hospital with complaints of fever, redness of eyes, swelling of lips with discharge and crusting, extensive erosions in the oral mucosa for the last 4 days, following consumption of allopurinol for a duration of 1 month. Investigations were within normal limits. The offending drug was withdrawn and he was treated with corticosteroids, antimicrobials, and other supportive measures. Allopurinol, a Xanthine oxidase inhibitor is mostly used for the treatment of primary and secondary hyperuricemia, Health care professionals must be aware of the spectrum of adverse effects of this drug and must take urgent measures once the diagnosis is suspected especially to save the patient from such severe or fatal reactions like SJS/Toxic epidermal necrolysis (TEN).

scholarly journals A case series of cefixime induced Steven’s Johnson Syndrome

2018 ◽  
Vol 7 (8) ◽  
pp. 1648
Author(s):  
Arikeri Vasu Deva Rao ◽  
Imran Khan ◽  
Srinivas Velupula ◽  
Jayababu N. ◽  
Samarasimha Reddy L. ◽  
...  
Keyword(s):  
Case Series ◽  
Stevens Johnson Syndrome ◽  
Allergic Reactions ◽  
Drug Induced ◽  
Major Health Problem ◽  
Johnson Syndrome ◽  
Eye Problems ◽  
Patient State ◽  
Life Threatening ◽  
Hyper Sensitivity

Drug induced adverse reactions are a major health problem. Drug hyper sensitivity reactions manifest themselves in many diseases, of which some are very severe. The most common allergic reactions occur in the skin. Stevens-Johnson syndrome is mainly caused by drugs (antimicrobials e.g.: penicillin’s, sulphonamides and cephalosporin’s e.g.: cefixime, antiepileptic’s, NSAIDS), infections and also by other risk factors not yet identified. The most common allergic reactions occur in the skin. These reactions ranging from simple pruritic eruptions to potentially life threatening events are a significant cause of iatrogenic morbidity and mortality. Identification of the cause, withdrawal of the trigger and supportive management is crucial to improve the patient state. Despite of all therapeutic efforts, mortality is high and increases with disease severity, patient’s age and underlying medical conditions. Survivors may suffer from long-term squeal such as strictures of mucous membranes including severe eye problems.

scholarly journals Blepharoconjunctivitis as Manifestation of Stevens-Johnson syndrome

2021 ◽  
Vol 5 (2) ◽  
pp. 26-32
Author(s):  
Putu Ayu Adindhya Saraswati Surya ◽  
Ni Nyoman Sunariasih
Keyword(s):  
Sharp Decrease ◽  
Stevens Johnson Syndrome ◽  
Eye Drops ◽  
Corneal Ulcers ◽  
Corneal Erosion ◽  
Ocular Manifestations ◽  
Johnson Syndrome ◽  
Mucous Membranes ◽  
Life Threatening ◽  
History Of

Background: Stevens Johnson syndrome (SJS) is a collection of acute and life threatening skin symptoms caused by an allergic drug reaction. SJS also attacks the other mucous membranes, one of which is the eye. SJS is a rare case. The initial complaint of SJS is the eruption on the skin in the form of redness followed by blisters and attacking other mucous membranes. The ocular manifestations of SJS are conjunctivitis, corneal erosion, corneal ulcers, and blepharitis. Methods: Treatment of SJS’s ocular manifestation is administration of drugs and surgical intervention. Administration of drugs that often done in the acute phase is antibiotic eye drops with steroids to prevent complications. Complications that can occur include symblepharon, districhiasis, and keratitis. This complication can cause a sharp decrease in vision. Results: This case report discusses a 68 year old male patient with blisters all over his body accompanied by swelling in both eyes, redness in both eyes, and difficult to open eyes. Patients with history of taking the new drug a month ago. No history of drug allergy. The patient suffered from hypertension, non-hemorrhagic stroke, and epilepsy with irregular treatment. Patient was performed a fluorescein test. In this case, the patient is given antibiotic ointment and artificial tears with steroids. In this case there were no complications. Conclusion: The ocular manifestations of SJS if handled quickly and properly can prevent long-term complications.

scholarly journals A case report of Stevens-Johnson syndrome and toxic epidermal necrolysis due to diclofenac sodium

2020 ◽  
Vol 9 (7) ◽  
pp. 1132
Author(s):  
Sreenivasa Rao Bendi ◽  
Tarun Kumar Suvvari
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Diclofenac Sodium ◽  
Skin Surface ◽  
Severe Form ◽  
Stevens Johnson Syndrome ◽  
Phenyl Acetic Acid ◽  
Disease Spectrum ◽  
Johnson Syndrome ◽  
Mucous Membranes ◽  
Severe Skin Reaction

Stevens-Johnson syndrome (SJS) is a severe skin reaction most often triggered by particular drugs in most of the cases. A more severe form of the condition is called toxic epidermal necrolysis (TEN) which involves more than 30% of the skin surface and extensive damage to the mucous membranes. SJS and TEN previously were thought to be separate conditions, but they are now considered part of a disease spectrum. The main drugs which induce SJS were anti-gout drugs, anti-epileptics, analgesics, NSAIDs and antibiotics. Diclofenac which is a NSAID and phenyl acetic acid derivative that rarely causes SJS. Although diclofenac induced Stevens-Johnson syndrome is reported very rare among adults, it shouldn’t be neglected. In this report we mentioned about the Stevens-Johnson syndrome (SJS) which was later developed into TEN due to usage diclofenac sodium, in a 65 years old female patient.

scholarly journals Nevirapine induced Stevens Johnson syndrome

2020 ◽  
Vol 1 (2) ◽  
pp. 35-38
Author(s):  
Himani Prajapati ◽  
Neetu Bala ◽  
Dinesh Kansal
Keyword(s):  
Adverse Effect ◽  
Adverse Event ◽  
Causality Assessment ◽  
Burning Sensation ◽  
The Body ◽  
Stevens Johnson Syndrome ◽  
Case Presentation ◽  
Johnson Syndrome ◽  
Life Threatening ◽  
History Of

Introduction: Severe and life-threatening SJS is more common with nevirapine than with other NNRTIs Case presentation: A 56-year-old male patient presented with a complaint of lesions all over the body with a burning sensation for 4 days. He was on an ART regimen, containing zidovudine, lamivudine, and efavirenz combination for 4 years. But patient accidentally started nevirapine and after 10 days he developed maculopapular lesions which were diagnosed as SJS syndrome. There was a history of rash with nevirapine when ART was started initially in 2012. This incident of an adverse event could be assigned a term "probable" according to the WHO-UMC scale for causality assessment as the re-challenge was found positive. Conclusion: Physicians and patients must be aware of this adverse effect on early diagnosis and treatment.

scholarly journals Severe dry eye associated with Steven Johnson Syndrome: A case report

2021 ◽  
Vol 7 (2) ◽  
pp. 225-228
Author(s):  
Namrata Shree ◽  
Baby Deka ◽  
Rajneel Bhattacharjee
Keyword(s):  
Dry Eye ◽  
Tear Film ◽  
Acute Stage ◽  
Stevens Johnson Syndrome ◽  
Corneal Surface ◽  
Eye Pain ◽  
Johnson Syndrome ◽  
Mucous Membranes ◽  
Life Threatening ◽  
Steven Johnson Syndrome

: Stevens-Johnson-Syndrome (SJS), and its severe variant, toxic epidermal necrolysis (TEN), are life-threatening diseases of skin and mucous membranes. Cases with pseudo-membrane formation and epithelial defects, have higher risk of ocular sequelae. Severe dry eye in SJS includes three mechanisms: (1) aqueous tear deficiency, (2) decreased wettability of corneal surface, and (3) increased evaporation.: A 47-year-old male patient presented in OPD with chief complaint of severe discomfort and grittiness in both eyes since last 21 years. Proper history taking and examination was done. Patient was given conservative treatment and was explained about recent advancements of treatment that can help in improving his condition.: In SJS patients, dryness causes eye pain, and unstable tear film causes diminution of vision. After acute stage reactions, visual impairment and severe dry eye are observed as ocular sequelae.

Stevens-Johnson syndrome

2016 ◽  
Vol 19 (4) ◽  
pp. 216-220
Author(s):  
O. Yu Olisova ◽  
O. V Grabovskaya ◽  
N. P Teplyuk ◽  
A. A Lepekhova ◽  
D. V Ignatiev ◽  
...  
Keyword(s):  
Clinical Case ◽  
Clinical Presentation ◽  
Stevens Johnson Syndrome ◽  
High Dose ◽  
Treatment And Prevention ◽  
Johnson Syndrome ◽  
Mucous Membranes ◽  
Systemic Glucocorticoids ◽  
Life Threatening ◽  
Methods Of Treatment

The literature review of the epidemiology, etiology and pathogenesis, clinical presentation and diagnosis of the syndrome of Stevens-Johnson severe life-threatening disease characterized by extensive lesions of the skin and mucous membranes, fever and bone and muscle aches, often induced by medication is presented. A review on the methods of treatment and prevention of this disease is presented. The clinical case of patient with the syndrome of Stevens-Johnson is described. The successful treatment of Syndrome Stevens-Johnson with high-dose systemic glucocorticoids was performed.

Norfloxacin-Induced Toxic Epidermal Necrolysis

2005 ◽  
Vol 39 (4) ◽  
pp. 768-770 ◽  
Author(s):  
Mustafa Turhan Sahin ◽  
Serap Ozturkcan ◽  
Isil Inanir ◽  
Elif E Filiz
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Causality Assessment ◽  
Case Reports ◽  
Oral Prednisolone ◽  
Stevens Johnson Syndrome ◽  
Medline Search ◽  
Case Summary ◽  
First Case ◽  
Johnson Syndrome ◽  
Severe Skin Reaction

OBJECTIVE: To report a case of toxic epidermal necrolysis (TEN) in a man who was treated with oral norfloxacin for prostatitis. CASE SUMMARY: A 40-year-old man presented with a severe skin reaction, which was diagnosed as TEN. He had received norfloxacin 800 mg/day over a 14-day period for prostatitis and, 10 days after finishing the treatment regimen, he developed cutaneous and mucous lesions typical of TEN. After a prolonged hospitalization and treatment with oral prednisolone therapy, fluid resuscitation, and wound dressing, the man recovered. DISCUSSION: TEN is an infrequent, yet often fatal, severe systemic and cutaneous disease that is most often an adverse drug reaction. There are few case reports of TEN induced by fluoroquinolones. A MEDLINE search (1966–February 2005) revealed no reports of toxic epidermal necrolysis, but one incidence of Stevens—Johnson syndrome due to norfloxacin therapy. An objective causality assessment suggests that TEN was probably related to norfloxacin in this patient. CONCLUSIONS: To our knowledge, this is the first case of TEN associated with the use of oral norfloxacin. We hope that this case report creates awareness that norfloxacin-induced TEN is possible.

scholarly journals Case Series of Three Patients with Rifampicin-Induced Thrombocytopenia

2020 ◽  
Author(s):  
Chandramouli M.T
Keyword(s):  
Pulmonary Tuberculosis ◽  
Adverse Reactions ◽  
Rare Complication ◽  
Case Series ◽  
Tuberculosis Treatment ◽  
Effective Drug ◽  
Antitubercular Drugs ◽  
Short Course ◽  
Life Threatening

AbstractLife-threatening adverse reactions of antitubercular drugs are uncommon; however, thrombocytopenia is one such rare complication encountered with rifampicin, isoniazid, ethambutol, and pyrazinamide. Rifampicin is the most effective drug and its use in the tuberculosis treatment led to the emergence of modern and effective short-course regimens. I am reporting case series of three patients with pulmonary tuberculosis presented with rifampicin-induced thrombocytopenia.

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