Cotrimoxazole
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Stevens-Johnson syndrome: case report A 18-year-old girl with septic shock developed StevensJohnson syndrome during treatment with cotrimoxazole [trimethoprim/sulfamethoxazole]. She subsequently died. The girl, who had juvenile systemic lupus erythematosus, had been hospitalised due to congestive heart failure and renal failure. While in hospital, she developed bacterial pneumonia and sepsis, which progressed to septic shock despite treatment with antibacterials. She subsequently received cotrimoxazole [dosage and route not stated] along with linezolid. Four days later, she developed erythematous lesions on her trunk, face and limbs. Over the next few hours, the lesions progressed to diffuse haemorrhagic vesicles and blisters, with positive Nikolsky’s sign. There was epidermal detachment over 5% of her body surface area; she also had conjunctivitis, cheilitis, oral erosions, haemorrhagic crust of the nasal mucosa, as well as vulval, vaginal and perianal involvement. The girl was treated with immunoglobulin; however, she died 3 days later from pulmonary haemorrhage. Autopsy findings included generalised infection and widespread subepidermal detachment with necrotic keratinocytes. Author comment: "Our patient presented with SJS [Stevens-Johnson syndrome] four days after treatment with this antimicrobial [cotrimoxazole] which seemed to be the most probable cause of this dermatological condition." Cavalcante EG, et al. Stevens-Johnson syndrome in a juvenile systemic lupus erythematosus patient. Lupus 20: 1439-1441, No. 13, Nov 2011. Available from: 803066758 URL: http://dx.doi.org/10.1177/0961203311408377 - Brazil
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Reactions 11 Feb 2012 No. 1388
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