Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis in a Nigerian Mother and Child
O. A. Oni1, P. O. Otuaga2, L. E. Ebite2, T. C. Ozoko3 and O. Aghimien41Consultant Physician, Niger Delta University Wilberforce Island, Amassoma Bayelsa State.
2Department of Anatomy, School of Basic Medical Sciences, College of health Sciences, Delta State University, Abraka, Delta State.
3Lecturer, Department of Medical Microbiology and Parasitology College of Health Sciences Delta State University, Abraka.
4Department of Pharmacy, UBTH, Benin City, Edo State.
Abstract: Stevens-Johnson syndrome(SJS) and Toxic epidermal necrolysis(TEN) are idiosyncratic immune complex mediated hypersensitivity reaction.Cytotoxic Hypersensitivity reaction has also be implicated especially in TEN which is a severe form of stevens- Johnson syndrome.In this article,we report a 13year old boy who was treated for a febrile ailment with a mixture of ampicillin and cotrimoxazole by his mother who also tasted the drug.Two weeks later,the child developed fever,sour throat,itching of the body,abdominal pain and later sloughing of the skin and mucous membrane of the mouth and nasal cavity.There was also conjunctivitis, dysphagia and dysuria.Inaddition,his mother presented with conjunctivitis,Sloughing of the oral mucosa and vaginal with few bullae around the vaginal orifice.The patients had mortality rates of 58.3% and 12.1% for the child and mother respectively(Severity of illness score).Both patients were admitted with the diagnosis of Stevens-Johnson syndrome(Mother) and Toxic epidermal necrolysis(Child).The offending drugs(ampicillin and cotrimoxazole) were withdrawn immediately after admission.Both patients survived and were discharged after vigorous treatment with tabs prednisolone, rehydration(IV normal saline),IV ciprofloxacin and gentamycin ointment.In addition,the patient who had toxic epidermal necrolysis was given Intra muscular injections of tetanus toxoid 0.5ml.
Keywords: Stevens-Johnson syndrome; Toxic epidermal necrolysis; idiosyncratic; cotrimoxazole; ampicillin Back to TOC