Open AccessHow to approach patients after Stevens‐Johnson syndrome with multiple drug involvement: test or not to test? To attest allergy to all involved drugs without testing?
Author(s) -
Kinaciyan Tamar
Publication year - 2014
Publication title -
clinical and translational allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.979
H-Index - 37
ISSN - 2045-7022
DOI - 10.1186/2045-7022-4-s3-p98
Subject(s) - medicine , cefuroxime , amoxicillin , clavulanic acid , penicillin , ampicillin , pneumonia , provocation test , dermatology , regimen , allergy , diclofenac , clarithromycin , doxycycline , antibiotics , anesthesia , immunology , microbiology and biotechnology , biology , helicobacter pylori , alternative medicine , pathology
Background A 36 years-old woman who suffered from Stevens-Johnson Syndrome (SJS) 9 months ago is reported. She was hospitalized for pneumonia with fever (39°C), cough and severe pain after 5 days of oral amoxicillin (AMX) and clavulanic acid treatment. Therapy was changed to cefuroxime i.v. and clarithromycin and acetylcysteine p.o. and diclofenac novalgin or perfalgan i.v. as needed. Two days later her general condition worsened, therefore therapy regimen was changed to ampicillin. She further developed conjunctivitis and later on erosive stomatitis. Two more days later coin-sized lesions arised on the back and rapidly generalized. The dermatology consultant diagnosed a SJS and took over the patient. All ongoing treatments were stopped, high dose, corticosteroids iv. and supportive treatment started. Bacterial and viral tests revealed a mycoplasma pneumonia which then was treated with doxycycline. After 3 weeks, she could be discharged and got an allergy passport for amoxicillin, clavulanic acid, paracetamol, NSAIDs, paracodein and due to possible cross-senstivity, all betalactams should be avoided.