A serious, painful drug rash


A 32-YEAR-OLD man presents with painful erosions around his lips, severe conjunctivitis and ‘blisters’ on the skin. 

He has been unwell with fever and a cough for the last two weeks and was commenced on an oral combined antibiotic of sulfamethoxazole and trimethoprim (Bactrim, Septrin) a week before. 

On examination he is febrile, listless and has features of a respiratory infection. He also has multiple target-like blisters along with mucosal erosion affecting the conjunctivae, lips and urethral opening. 

What is the likely diagnosis?

Stevens-Johnson syndrome 

Stevens-Johnson syndrome (SJS)is a serious condition with a mortality of up to 30%. 

The condition is  usually triggered by medications (majority) and some infections.