A serious, painful drug rash
21st June 2011
Scenario
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.