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 Amoxicillin Induced Steven Johnson’s Syndrome: A Case Report

2020 ◽  
Vol 10 (4-s) ◽  
pp. 220-222
Author(s):  
R Mahendra Kumar ◽  
Sanatkumar Nyamagoud ◽  
Krishna Deshpande ◽  
Ankitha Kotian
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Case Reports ◽  
The Body ◽  
Stevens Johnson Syndrome ◽  
Hypersensitivity Reactions ◽  
Johnson Syndrome ◽  
Oral Consumption ◽  
Life Threatening

Stevens-Johnson syndrome (SJS) is a very rare, potentially fatal skin reaction that is typically the result of reaction to the drug. In particular, SJS is characterized by extensive skin and mucous membrane lesions (i.e. mouth, nose, esophagus, anus, and genitalia), epidermis detachment, and acute skin blisters. In 95 % of case reports, drugs were found to be an important cause for the development of SJS. This story is a case of A 42 year old male hospitalized with rashes all over the body and fever, after oral consumption of Amoxicillin drug for sore throat. This case study discusses the possibility that serious hypersensitivity reactions with Amoxicillin can rarely occur and can be extremely harmful and life-threatening Menacing. Keywords: Toxic Epidermal Necrolysis, Stevens Johnson Syndrome, Adverse drug reaction, Nikolsky’s sign

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.

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 Serum Granulysin in Differentiation of Stevens-Johnson Syndrome/toxic Epidermal Necrolysis and Erythema Multiforme

2020 ◽  
Vol 8 (B) ◽  
pp. 381-388
Author(s):  
Tran Thi Huyen ◽  
Pham Dinh Hoa ◽  
Trinh Minh Trang ◽  
Riichiro Abe ◽  
Nguyen Van Thuong ◽  
...  
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Body Surface ◽  
Erythema Multiforme ◽  
The Body ◽  
Stevens Johnson Syndrome ◽  
Enzyme Linked Immunosorbent Assay ◽  
Drug Reactions ◽  
Skin Manifestation ◽  
Johnson Syndrome ◽  
Life Threatening

BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are acute, life-threatening drug reactions, which lead to massive epidermal necrolysis. Granulysin plays an important role as a key mediator for keratinocyte apoptosis in these conditions. Erythema multiforme (EM) may have skin manifestation similar to SJS/TEN. AIMS: The aim of the study was to compare serum granulysin levels in patients with SJS/TEN and EM as well as to investigate a possible association between serum granulysin levels and the severity of SJS/TEN. METHODS: In total, 48 patients with SJS/TEN, 43 patients with EM, and 20 health controls (HCs) were enrolled. We measured serum granulysin levels using enzyme-linked immunosorbent assay. RESULTS: The average level of serum granulysin in the SJS/TEN patients was 23.0 ng/ml (range 1.2–144.6 ng/ml), significantly higher than that of EM group (20.1 ng/ml; range 8.5–121 ng/ml, p < 0.05) and HCs group (20.8 ng/ml; range 10.1–46.7 ng/ml, p < 0.05). Of 48 SJS/TEN patients, the 25 samples collected <6 days after onset showed higher level of serum granulysin (27.7 ng/ml; range 2.5–144.6 ng/ml) than those collected ≥6 days after onset (17.9 ng/ml; range 1.2–59 ng/ml; p > 0.05). No significant correlation was found between serum granulysin levels and the body surface area affected and the modified-SCORTEN. At the day of re-epithelialization, serum granulysin levels were not different compared with those at the day of hospitalization. CONCLUSIONS: Serum granulysin levels are significantly higher in SJS/TEN group than in EM group. After the onset, serum granulysin levels in patients with SJS/TEN are not a good biomarker to evaluate the severity of the diseases.

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.

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.

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 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 Carbamazepine induced Stevens Johnson Syndrome: a case report from a tertiary care hospital

2018 ◽  
Vol 7 (8) ◽  
pp. 1654
Author(s):  
Jyoti B. Gadhade ◽  
Rajesh S. Hiray ◽  
Balasaheb B. Ghongane
Keyword(s):  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
The Body ◽  
Stevens Johnson Syndrome ◽  
Care Hospital ◽  
Common Cause ◽  
Johnson Syndrome ◽  
Intravenous Antibiotics ◽  
Life Threatening ◽  
Ulcerative Lesions

Stevens Johnson Syndrome is a rare but life-threatening skin disease and Carbamazepine is considered as one of the most common cause. The reported frequency of serious Carbamazepine hypersensitivity reaction is between 1/1000 and 1/10000 new exposures to the drug. Here, we report a case of a 40 year old female patient, who developed multiple ulcerative lesions all over the body three days after starting treatment with Carbamazepine for Trigeminal Neuralgia. (Worldwide Unique Number- 2017-58502 and AMC Report Number- BJGMC-Pune/Nov-2017/BBG-1860) Stevens Johnson Syndrome was diagnosed. Carbamazepine was withdrawn, and the patient was treated with topical and intravenous antibiotics. A biopsy was done which confirmed the diagnosis of Stevens Johnson Syndrome.

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