Here we discussed a case of 39 year old women who developed drug induced steven Johnson syndrome (SJS). she was on Amoxicillin - Clavulanic acid(penicillin antibiotic) and Paracetamol for the management of fever and cough. Later she developed peeling of skin over lips , painful reddish lesions over 75% of her skin surface including back of trunk, front of chest, hands, legs, palms and soles. Her eyes, mouth and genital organs were also affected.
Blood investigations revealed LFT was elevated herpes simplex virus IgM was borderline and IgG HSV was elevated( 5.5). her blood cultures were negative.
Patients symptoms started to develop on 2nd day of treatment with amoxicillin/clavulanic acid( Augmentin) 625mg OD. adverse reaction was managed with IV steroids,oral cyclosporine and other conservative measures. After 2 weeks her lesions subsided and steroids were tapered. During her discharge, she was haemodynamically stable, LFT was improved and her lesions were exfoliating.
Health care providers must be careful regarding the adverse effects of the drugs especially the one is the Stevens-Johnson syndrome (SJS) which is a potentially fatal condition with mortality rate below 5 percent.
This reaction is of shorter duration and with rechallenge. The most commonly and widely prescribed drug regimens should also be used judiciously and continuously monitored to prevent such a fatal adverse drug reactions.
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