Toxic epidermal necrolysis in the practice of a family doctor

2020 ◽  
pp. 61-67
Author(s):  
Esed Esedov ◽  
Fariza Akhmedova ◽  
Dina Akbiyeva
Keyword(s):  
Allergic Reaction ◽  
Toxic Epidermal Necrolysis ◽  
Family Doctor ◽  
Favorable Outcome ◽  
Rational Treatment ◽  
Systemic Allergic Reaction ◽  
Timely Diagnosis ◽  
First Case ◽  
Mucous Membranes

Toxic epidermal necrolysis is a severe delayed-type systemic allergic reaction, in which there is a combined lesion of the skin and mucous membranes. 2 cases of toxic epidermal necrolysis from the practice of a family doctor are described in the article. Timely diagnosis and rational treatment of the disease in the first case led to a favorable outcome, in the second case, the outcome of the disease was unfavorable.

scholarly journals A case report of toxic epidermal necrolysis (TEN) in a patient with COVID-19 treated with hydroxychloroquine: are these two partners in crime?

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Carlo Maria Rossi ◽  
Flavio Niccolò Beretta ◽  
Grazia Traverso ◽  
Sandro Mancarella ◽  
Davide Zenoni
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Fatal Outcome ◽  
Total Body Surface Area ◽  
Stevens Johnson Syndrome ◽  
First Case ◽  
Cutaneous Adverse Reaction ◽  
Johnson Syndrome ◽  
Mucous Membranes ◽  
Total Body ◽  
The Moment

Abstract Background Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis (SJS/TEN) is the most Serious Cutaneous Adverse Reaction (SCAR) often with a fatal outcome. Coronavirus Disease (COVID-19) is caused by Severe Acute Respiratory Syndrome–Coronavirus—2 (SARS-COV2) and is an emergent pandemic for which no cure exist at the moment. Several drugs have been tried often with scant clinical evidence and safety. Case presentation Here we report the case of 78-years-old woman with cardiometabolic syndrome and COVID-19. A multidrug regimen including others hydroxychloroquine, antibiotics, dexamethasone and paracetamol, low-molecular-weight-heparin and potassium canrenoate was started. After almost 3 weeks, the patient started to display a violaceous rash initially involving the flexural folds atypical targetoid lesions and showing a very fast extension, blister formation and skin detachments of approximately 70% of the total body surface area and mucous membranes involvement consistent with toxic epidermal necrolysis (TEN). The ALDEN algorithm was calculated inserting all drugs given to the patient in the 28 days preceding the onset of the skin manifestations. The highest score retrieved was for hydroxychloroquine. Other less suspicious drugs were piperacillin/tazobactam, ceftriaxone and levofloxacin. Conclusions To our knowledge, this is the first case of TEN in a patient suffering from COVID-19 probably associated with hydroxychloroquine. Given the activation of the immune system syndrome induced by the virus and the widespread off-label use of this drug, we suggest a careful monitoring of skin and mucous membranes in all COVID-19 positive patients treated with hydroxychloroquine in order to early detect early signs of toxicities.

scholarly journals Correction of Stevens-Jonson syndrome - an adverse event of antibiotic therapy

2015 ◽  
Vol 12 (6) ◽  
pp. 68-71
Author(s):  
O V Fatenkov ◽  
T M Kuzmina ◽  
O A Rubanenko ◽  
O I Lobankova ◽  
E A Arsenjeva
Keyword(s):  
Adverse Event ◽  
Allergic Reaction ◽  
Clinical Case ◽  
Who Classification ◽  
Adverse Reactions ◽  
Stevens Johnson Syndrome ◽  
Type B ◽  
Systemic Allergic Reaction ◽  
Johnson Syndrome ◽  
Mucous Membranes

Stevens-Johnson syndrome refers to the type B of adverse reactions to drugs according to WHO classification and is severe systemic allergic reaction of delayed type. This syndrome is a severe variant of multiform erythema in which both skin and mucous membranes symptoms are observed. In the article literature data on etiology, pathogenesis and treatment of Stevens-Johnson syndrome as well as clinical case of 24 years old woman with this syndrome are represented.

Systemic allergic reaction by a human insulin analog

Allergy ◽  
2003 ◽  
Vol 58 (6) ◽  
pp. 536-537 ◽  
Author(s):  
R. Barranco ◽  
T. Herrero ◽  
P. Tornero ◽  
M. Barrio ◽  
C. Frutos ◽  
...  
Keyword(s):  
Allergic Reaction ◽  
Human Insulin ◽  
Insulin Analog ◽  
Systemic Allergic Reaction

scholarly journals Stevens - Johnson Syndrome and Toxic Epidermal Necrolysis; Extensive Review of Reports of Drug-Induced Etiologies, and Possible Therapeutic Modalities

2018 ◽  
Vol 6 (4) ◽  
pp. 730-738 ◽  
Author(s):  
Adegbenro Omotuyi John Fakoya ◽  
Princess Omenyi ◽  
Precious Anthony ◽  
Favour Anthony ◽  
Precious Etti ◽  
...  
Keyword(s):  
Adverse Drug Reaction ◽  
Toxic Epidermal Necrolysis ◽  
Stevens Johnson Syndrome ◽  
Hypersensitivity Reactions ◽  
Extensive Review ◽  
Drug Induced ◽  
Therapeutic Modalities ◽  
Johnson Syndrome ◽  
Mucous Membranes ◽  
Degrees Of Severity

Stevens - Johnson Syndrome and Toxic Epidermal Necrolysis are adverse hypersensitivity reactions that affect the skin and mucous membranes. They are characterised by erythematous macules and hemorrhagic erosions of the mucous membranes. Epidermal detachments of varying degrees of severity also occur in these conditions. Various aetiologies are associated with these conditions, with adverse drug reaction being the most common. Though the worldwide incidence of these conditions is recorded as low, diverse types of medication are being observed to lead to these conditions. This review compiles information on the details of Stevens-Johnson syndrome and Toxic Epidermal Necrolysis, the pathophysiology, therapeutic management, and largely considers the drug-induced etiologies associated with these conditions.

SYSTEMIC ALLERGIC REACTION TO INITIAL INSULIN THERAPY IN A JUVENILE DIABETIC.

1975 ◽  
Vol 64 (5) ◽  
pp. 773-776
Author(s):  
C. DACOU-VOUTETAKIS ◽  
TH. THOMAIDIS ◽  
E. ROMA ◽  
A. KALPINI-MAVROU ◽  
C. ECONOMOU-MAVROU
Keyword(s):  
Allergic Reaction ◽  
Insulin Therapy ◽  
Systemic Allergic Reaction ◽  
Juvenile Diabetic

scholarly journals A case report of community-acquired Raoultella ornithinolytica infection in a healthy, young individual

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaonan Chen ◽  
Xinjian Zhou ◽  
Jun Cao ◽  
Ke Ma ◽  
Zhijie Xia
Keyword(s):  
Allergic Reaction ◽  
High Throughput Sequencing ◽  
Maculopapular Rash ◽  
Skin Condition ◽  
Sequencing Analysis ◽  
First Case ◽  
Lymph Node Enlargement ◽  
History Of ◽  
Tract Infections ◽  
Healthcare Associated

Abstract Background Raoultella ornithinolytica is a Gram-negative bacillus that resembles Klebsiella. This bacterium is present in many soil and aquatic environments and is a major causative agent of healthcare-associated infections (HAIs) in medical staff. Clinically, it has been reported to contribute to nosocomial infections in patients that include but are not limited to gastrointestinal, skin, and genitourinary tract infections. These complications are most common in hospitalized patients with underlying immunodeficiency, multiple comorbidities, or those receiving invasive surgery. Case presentation We present a case of a 25-year-old patient with a R. ornithinolytica infection. The patient had no history of any disease. Her main complaints were high fever, a scattered maculopapular rash, and superficial lymph node enlargement (SLNE). Peripheral blood samples were collected for high-throughput sequencing analysis to identify pathogenic microorganisms. The results confirmed a R. ornithinolytica infection, which was treated successfully using meropenem. Loratadine was also administered to treat the patient’s compromised skin condition caused by an allergic reaction. Conclusions To our knowledge, this is the first case of a systemic maculopapular rash and superficial lymphadenopathy caused by a R. ornithinolytica infection acquired at the community level. Based on this case, we recommend a combination of antibiotic and antiallergic drugs to treat a R. ornithinolytica infection and associated allergic reaction to the bacteria.

Head and Neck Manifestations of Erythema Multiforme in Children

1994 ◽  
Vol 111 (3P1) ◽  
pp. 236-242 ◽  
Author(s):  
Michael G. Stewart ◽  
Newton O. Duncan ◽  
Daniel J. Franklin ◽  
Ellen M. Friedman ◽  
Marcelle Sulek
Keyword(s):  
Oral Cavity ◽  
Toxic Epidermal Necrolysis ◽  
Head And Neck ◽  
Erythema Multiforme ◽  
Medication Use ◽  
Stevens Johnson Syndrome ◽  
Striking Increase ◽  
Johnson Syndrome ◽  
Mucosal Involvement ◽  
Mucous Membranes

Erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis are related disorders of skin and mucous membranes, which are typically associated with antecedent medication use or infection. We review 108 cases of erythema multiforme, Stevens-Johnson syndrome, and toxic epidermal necrolysis from Texas Children's Hospital, Houston, Texas, from 1981 to 1991, and illustrate the characteristic skin and mucosal lesions. In addition, we describe in detail two unusual cases requiring intensive airway management. Head and neck manifestations were present in 4 of 79 patients (5%) with erythema multiforme and 26 of 28 patients (93%) with Stevens-Johnson syndrome. In Stevens-Johnson syndrome, mucosal involvement of the lip (93%), conjunctiva (82%), oral cavity (79%), and nose (36%) were most common. Antecedent medication use was identified in 59% of erythema multiforme patients and 68% of Stevens-Johnson syndrome patients. We note a striking increase in the number of cases in our series caused by cephalosporins. Fifty percent of Stevens-Johnson syndrome patients required supplemental hydration or alimentation because of the severity of the oral cavity involvement. The head and neck mucosal manifestations largely respond to local care, and the routine use of prophylactic antibiotics or systemic steroids is not recommended.

BACKGROUND OF THE CCHF PATHOGEN CIRCULATION IN THE SOUTHERN REGION OF KAZAKHSTAN AND LABORATORY DIAGNOSTICS OF THE CONGO-CRIMEAN HEMORRHAGIC FEVER

Vestnik ◽  
2021 ◽  
pp. 29-34
Author(s):  
У.А. Укибаева ◽  
Г.М. Омашева ◽  
А.Б. Даниярова ◽  
Э.У. Бойбосинов ◽  
А.А. Белходжаев ◽  
...  
Keyword(s):  
Laboratory Tests ◽  
Molecular Genetic ◽  
Clinical Manifestations ◽  
Hemorrhagic Fever ◽  
Southern Region ◽  
Favorable Outcome ◽  
Laboratory Evaluation ◽  
Laboratory Diagnostics ◽  
Timely Diagnosis ◽  
Adequate Therapy

Своевременная диагностика ККГЛ, прогнозирование геморрагического синдрома и адекватная терапия часто определяют благоприятный исход заболевания. Лабораторная оценка клинических проявлений ККГЛ проводится гематологическими, биохимическими, гемостазиологическими лабораторными испытаниями. Подтверждение диагноза осуществляется иммунологическими, молекулярно-генетическими и вирусологическими методами. Timely diagnosis of CCHF, prognosis of hemorrhagic syndrome and adequate therapy often determine a favorable outcome of the disease. Laboratory evaluation of clinical manifestations of CCHF is carried out by hematological, biochemical, and hemostasiological laboratory tests. Confirmation of the diagnosis is carried out by immunological, molecular-genetic and virological methods.

A Systemic Allergic Reaction to Nickel Requiring Explantation of a Septal Occluder Device

Dermatitis ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Guillemette Salomon ◽  
Célia Toulouse ◽  
Sébastien Hascoet ◽  
Fabio Cuttone ◽  
Nathalie Souletie ◽  
...  
Keyword(s):  
Allergic Reaction ◽  
Systemic Allergic Reaction ◽  
Septal Occluder Device ◽  
Occluder Device

Oncological emergencies

2007 ◽  
pp. 655-674
Keyword(s):  
Spinal Cord ◽  
Allergic Reaction ◽  
Disseminated Intravascular Coagulation ◽  
Superior Vena ◽  
Vena Cava ◽  
Cord Compression ◽  
Tumour Lysis ◽  
System Involvement ◽  
Intravascular Coagulation ◽  
Systemic Allergic Reaction

Anaphylaxis 656 Disseminated intravascular coagulation 658 Malignancy induced hypercalcaemia 660 Spinal cord compression 664 Superior vena cava obstruction 668 Syndrome of inappropriate antidiuretic hormone 670 Tumour lysis syndrome 672 Anaphylaxis is a severe systemic allergic reaction with multi-system involvement. Onset is normally immediate, but there can be a delay of hours....

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