Possible Cefotaxime-Induced Stevens–Johnson Syndrome

2003 ◽  
Vol 37 (6) ◽  
pp. 812-814 ◽  
Author(s):  
Evagelos N Liberopoulos ◽  
George L Liamis ◽  
Moses S Elisaf
Keyword(s):  
Case Control Study ◽  
Causality Assessment ◽  
Clinical Manifestations ◽  
Underlying Mechanism ◽  
Upper Urinary Tract ◽  
Stevens Johnson Syndrome ◽  
Case Summary ◽  
Johnson Syndrome ◽  
Increased Risk ◽  
Control Study

OBJECTIVE: To report a case of possible cefotaxime-induced Stevens–Johnson syndrome (SJS). CASE SUMMARY: A 72-year-old woman with an upper urinary tract infection developed erosions and blisters on the skin and the mucous membranes, as well as fever and prostration, soon after the administration of cefotaxime. This presentation is consistent with the features of SJS. Resolution of the clinical manifestations was observed after discontinuation of the drug; all other drugs, infections, or immunologic disorders that could have caused this syndrome were carefully excluded. An objective causality assessment revealed that SJS was possibly associated with the use of cefotaxime. DISCUSSION: Although cephalosporins have been associated with an increased risk for SJS and cefotaxime has been suspected of being associated with SJS in a previous case–control study, this is the first full report for cefotaxime-related SJS in the literature. An immunologically mediated reaction may be the underlying mechanism. CONCLUSIONS: Although cefotaxime administration seems to be the underlying cause of the SJS observed in our patient, establishment of a definite causal relationship requires additional cases and supportive data.

HLA-A*24:07 as a potential biomarker for carbamazepine-induced Stevens–Johnson syndrome/toxic epidermal necrolysis in Filipino patients

2021 ◽  
Author(s):  
Francis Capule ◽  
Pramote Tragulpiankit ◽  
Surakameth Mahasirimongkol ◽  
Jiraphun Jittikoon ◽  
Nuanjun Wichukchinda ◽  
...  
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Medical Records ◽  
Odds Ratio ◽  
Genomic Dna ◽  
Case Control Study ◽  
Case Control ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome ◽  
Potential Biomarker ◽  
Control Study

Aim: A case-control study was conducted in Filipino patients to determine the association between HLA alleles and carbamazepine-induced Stevens–Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN). Materials & methods: A retrospective review of medical records and data collection were performed. A total of 10 carbamazepine-induced SJS/TEN cases and 40 tolerant controls were recruited. Genomic DNA extracted from saliva samples was genotyped. Statistical analysis was done. Results: The HLA-B75 serotype (p = 0.003; odds ratio [OR] = 13.8; 95% CI = 2.5–76.8), HLA-B*15:21 (p = 0.041; OR = 4.7; 95% CI = 1.1–20.8) and HLA-A*24:07 (p = 0.032; OR = 6; 95% CI = 1.2–30.7) were significantly associated with carbamazepine-induced SJS/TEN. Conclusion: The HLA-B75 serotype, HLA-B*15:21 or HLA-A*24:07 may be used for pharmacogenetic screening prior to prescribing carbamazepine in Filipinos.

scholarly journals Stevens-Johnson Syndrome Associated with Drugs and Vaccines in Children: A Case-Control Study

PLoS ONE ◽  
2013 ◽  
Vol 8 (7) ◽  
pp. e68231 ◽  
Author(s):  
Umberto Raucci ◽  
Rossella Rossi ◽  
Roberto Da Cas ◽  
Concita Rafaniello ◽  
Nadia Mores ◽  
...  
Keyword(s):  
Case Control Study ◽  
Case Control ◽  
Stevens Johnson Syndrome ◽  
Johnson Syndrome ◽  
Control Study

Incidence of Stevens-Johnson syndrome following combination drug use of allopurinol, carbamazepine and phenytoin in Taiwan: A case-control study

2018 ◽  
Vol 45 (9) ◽  
pp. 1080-1087 ◽  
Author(s):  
Fei-Kai Syu ◽  
Hsiu-Yung Pan ◽  
Po-Chun Chuang ◽  
Yi-Syun Huang ◽  
Chi-Yung Cheng ◽  
...  
Keyword(s):  
Drug Use ◽  
Case Control Study ◽  
Case Control ◽  
Stevens Johnson Syndrome ◽  
Combination Drug ◽  
Johnson Syndrome ◽  
Control Study

scholarly journals Association between HLA-B Alleles and Carbamazepine-Induced Maculopapular Exanthema and Severe Cutaneous Reactions in Thai Patients

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Chonlaphat Sukasem ◽  
Chonlawat Chaichan ◽  
Thapanat Nakkrut ◽  
Patompong Satapornpong ◽  
Kanoot Jaruthamsophon ◽  
...  
Keyword(s):  
Case Control Study ◽  
Strong Association ◽  
Case Control ◽  
Stevens Johnson Syndrome ◽  
Thai Population ◽  
Johnson Syndrome ◽  
Cutaneous Reactions ◽  
Systemic Symptoms ◽  
Maculopapular Exanthema ◽  
Control Study

The HLA-B∗15:02 allele has been reported to have a strong association with carbamazepine-induced Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) in Thai patients. The HLA-B alleles associated with carbamazepine-induced maculopapular exanthema (MPE) and the drug reaction with eosinophilia and systemic symptoms (DRESS) among the Thai population have never been reported. The aim of the present study was to carry out an analysis of the involvement of HLA-B alleles in carbamazepine-induced cutaneous adverse drug reactions (cADRs) in the Thai population. A case-control study was performed by genotyping the HLA-B alleles of Thai carbamazepine-induced hypersensitivity reaction patients (17 MPE, 16 SJS/TEN, and 5 DRESS) and 271 carbamazepine-tolerant controls. We also recruited 470 healthy Thai candidate subjects who had not taken carbamazepine. HLA-B∗15:02 showed a significant association with carbamazepine-induced MPE (P=0.0022, odds ratio (OR) (95% confidence interval [CI]) = 7.27 (2.04–25.97)) and carbamazepine-induced SJS/TEN (P=4.46×10−13; OR (95% CI) = 70.91(19.67–255.65)) when compared with carbamazepine-tolerant controls. Carbamazepine-induced SJS/TEN also showed an association with HLA-B∗15:21 allele (P=0.013; OR (95% CI) = 9.54 (1.61–56.57)) when compared with carbamazepine-tolerant controls. HLA-B∗58:01 allele was significantly related to carbamazepine-induced MPE (P=0.007; OR (95% CI) = 4.73 (1.53–14.66)) and DRESS (P=0.0315; OR (95% CI) = 7.55 (1.20–47.58)) when compared with carbamazepine-tolerant controls. These alleles may serve as markers to predict carbamazepine-induced cADRs in the Thai population.

scholarly journals Cefotaxime-induced Stevens-Johnson syndrome

2016 ◽  
Vol 7 (6) ◽  
pp. 87-90
Author(s):  
Sandeep Lahiry ◽  
Dibyendu Mukherjee
Keyword(s):  
Causality Assessment ◽  
Clinical Manifestations ◽  
Clinical Syndrome ◽  
Stevens Johnson Syndrome ◽  
Hypersensitivity Reactions ◽  
Medical Sciences ◽  
Johnson Syndrome ◽  
Common Causes ◽  
Initial Lesions ◽  
Dermal Lesions

Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are severe cutaneous immune-complex hypersensitivity reactions. Drugs, especially sulfa drugs, antiepileptics, and antibiotics like cephalosporins, are the most common causes. Maculopapular lesions rapidly spread and coalesce, leading to epidermal blistering, necrosis, and sloughing. Diagnosis is usually obvious by appearance of initial lesions and clinical syndrome. Treatment is supportive care; cyclosporine, plasma exchange or IVIG, and early pulse corticosteroid therapy have been used. Mortality can be as high as 7.5% in children and 20 to 25% in adults but tends to be lower with early treatment.Here, we present a case of a 26year old female who presented with extensive dermal lesions and ocular findings including periorbital skin scarring, conjunctivitis with corneal erosions, as well as fever and prostration, soon after the administration of cefotaxime. Epidermal detachment was observed in <10% of her body surface. This presentation is consistent with the features of SJS. Resolution of the clinical manifestations was observed after discontinuation of the drug; all other drugs, infections, or immunologic disorders that could have caused this syndrome were carefully excluded. An objective causality assessment revealed that SJS was possibly associated with the use of cefotaxime.Asian Journal of Medical Sciences Vol.7(5) 2016 87-90

Risk of Stevens-Johnson syndrome and toxic epider mal necrolysis during first weeks of antiepileptic therapy: a case-control study

The Lancet ◽  
1999 ◽  
Vol 353 (9171) ◽  
pp. 2190-2194 ◽  
Author(s):  
Berthold Rzany ◽  
Osvaldo Correia ◽  
Judith P Kelly ◽  
Luigi Naldi ◽  
Ariane Auquier ◽  
...  
Keyword(s):  
Case Control Study ◽  
Case Control ◽  
Stevens Johnson Syndrome ◽  
Antiepileptic Therapy ◽  
Johnson Syndrome ◽  
Control Study

Norfloxacin-Induced Toxic Epidermal Necrolysis

2005 ◽  
Vol 39 (4) ◽  
pp. 768-770 ◽  
Author(s):  
Mustafa Turhan Sahin ◽  
Serap Ozturkcan ◽  
Isil Inanir ◽  
Elif E Filiz
Keyword(s):  
Toxic Epidermal Necrolysis ◽  
Causality Assessment ◽  
Case Reports ◽  
Oral Prednisolone ◽  
Stevens Johnson Syndrome ◽  
Medline Search ◽  
Case Summary ◽  
First Case ◽  
Johnson Syndrome ◽  
Severe Skin Reaction

OBJECTIVE: To report a case of toxic epidermal necrolysis (TEN) in a man who was treated with oral norfloxacin for prostatitis. CASE SUMMARY: A 40-year-old man presented with a severe skin reaction, which was diagnosed as TEN. He had received norfloxacin 800 mg/day over a 14-day period for prostatitis and, 10 days after finishing the treatment regimen, he developed cutaneous and mucous lesions typical of TEN. After a prolonged hospitalization and treatment with oral prednisolone therapy, fluid resuscitation, and wound dressing, the man recovered. DISCUSSION: TEN is an infrequent, yet often fatal, severe systemic and cutaneous disease that is most often an adverse drug reaction. There are few case reports of TEN induced by fluoroquinolones. A MEDLINE search (1966–February 2005) revealed no reports of toxic epidermal necrolysis, but one incidence of Stevens—Johnson syndrome due to norfloxacin therapy. An objective causality assessment suggests that TEN was probably related to norfloxacin in this patient. CONCLUSIONS: To our knowledge, this is the first case of TEN associated with the use of oral norfloxacin. We hope that this case report creates awareness that norfloxacin-induced TEN is possible.

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