Toxic epidermal necrolysis in a 37-year-old man with pneumonia: a case report

Wiryanti Ambarita, Sri Lestari, Anwar Fuadi, A. Raza
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Abstract

Apart from allergy, TEN can be caused by infection, such as M. pneumoniae infection. Aim of this case report is to present clinical manifestations of TEN with pneumonia. A 37-year-old man, came to the emergency room with cough and fever since 5 days before hospitalized. The patient received intravenous ceftriaxone (with negative skin test), paracetamol, and n-acetylcysteine. Three days earlier, the patient had gone to primary health center and got paracetamol and n-acetylcysteine. On the first day of treatment, erythematous macules were seen on the anterior and posterior thoracic region, also the patient had sore throat and dysphagia, treated with intravenous dipenhydramine, mefenamic acid, and cetirizine. On the following day, the lesions expanded with multiple bullae on the anterior and posterior thoracic region, and erosion on the labia (BSA 28%). Intravenous methylprednisolone was administered, also Kloderma® and Ikagen® cream, and Kenalog®. Mefenamic acid and paracetamol were discontinued. On the third day of treatment, the lesions expanded (BSA 38%) and the next day, BSA reached 91.5%. The SCORTEN was 1. The patient was referred for treatment at the burn center and IVIg therapy. After the eleventh day of treatment at the referral hospital, the patient was fully recovered. The managements of TEN are stop suspected drugs, wound care, fluid therapy, systemic corticosteroids, and IVIg therapy. Appropriate management of TEN gives complete recovery to patient.
一名患有肺炎的 37 岁男子的中毒性表皮坏死症:病例报告
除过敏外,TEN 还可能由感染引起,如肺炎双球菌感染。本病例报告旨在介绍 TEN 并发肺炎的临床表现。一名 37 岁的男子因咳嗽和发烧 5 天前来急诊就诊,然后住院治疗。患者静脉注射了头孢曲松(皮试阴性)、扑热息痛和正乙酰半胱氨酸。三天前,患者曾到初级保健中心就诊,并服用了扑热息痛和正乙酰半胱氨酸。治疗第一天,患者胸部前后出现红斑,并伴有咽喉疼痛和吞咽困难,静脉注射了苯海拉明、甲氰咪胍和西替利嗪。次日,病变扩大,胸前和胸后区域出现多个包块,阴唇出现糜烂(BSA 28%)。患者接受了甲基强的松龙静脉注射,还使用了 Kloderma® 和 Ikagen® 乳膏以及 Kenalog®。停用了甲灭酸和扑热息痛。治疗第三天,皮损扩大(BSA 38%),第二天,BSA 达到 91.5%。SCORTEN 为 1。患者被转到烧伤中心治疗,并接受了 IVIg 治疗。在转诊医院治疗第 11 天后,患者完全康复。TEN 的治疗方法包括停用可疑药物、伤口护理、输液治疗、全身皮质类固醇激素和 IVIg 治疗。对 TEN 的适当处理可使患者完全康复。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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