一名年轻女性与非甾体抗炎药引发的中毒性表皮坏死症的斗争:病例报告。

IF 1.7 Q2 MEDICINE, GENERAL & INTERNAL
Annals of Medicine and Surgery Pub Date : 2024-09-30 eCollection Date: 2024-11-01 DOI:10.1097/MS9.0000000000002625
Pratik Adhikari, Uday Singh, Pramodman S Yadav, Leeza Shah, Abinash Dev, Subhash C Mandal
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引用次数: 0

摘要

简介史蒂文斯-约翰逊综合征(Stevens-Johnson Syndrome,SJS)是一种罕见但严重的皮肤粘膜反应,通常由药物或感染引发,其特点是表皮广泛脱落和粘膜受累。这种病症的发病率和死亡率都很高,需要及时识别和治疗:一名来自尼泊尔东部的 18 岁亚裔女性,因轻微溃疡服用布洛芬后出现不痒的红斑、高烧和明显不适。她的皮肤广泛受累,覆盖了25%的体表面积,并出现严重的粘膜病变。实验室检查显示她患有贫血、白细胞增多和凝血功能障碍。她被送入重症监护室,接受了广谱抗生素、皮质类固醇激素和支持性治疗。在治疗期间,患者还出现了急性肾损伤,但最终在一周后康复出院:临床讨论:该患者的SJS发病迅速,揭示了药物诱发反应的不可预测性。皮肤科、重症监护和传染病专家参与的多学科早期干预对控制病情至关重要。尽管在 SJS 中使用皮质类固醇存在争议,但使用皮质类固醇可能有助于炎症的迅速改善和皮肤的愈合。该病例强调了早期识别、及时处理和仔细监测药物不良反应的重要性,尤其是在处方已知可导致SJS的药物时:结论:通过多学科方法取得的成功结果为处理严重药物反应的有效策略提供了宝贵的启示,强调了早期诊断和全面管理 SJS 患者至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A young female's battle with toxic epidermal necrolysis induced by NSAIDs: a case report.

Introduction: Stevens-Johnson Syndrome (SJS) is a rare but severe mucocutaneous reaction often triggered by medications or infections, characterized by extensive epidermal detachment and mucosal involvement. This condition poses a high risk of morbidity and mortality, requiring prompt recognition and treatment.

Case presentation: An 18-year-old Asian female from eastern Nepal presented with nonitchy red spots, high fever, and significant discomfort following the administration of ibuprofen for minor sores. She developed extensive skin involvement covering 25% of her body surface area and severe mucosal lesions. Laboratory investigations revealed anemia, leukocytosis, and coagulopathy. She was admitted to the ICU, where she received broad-spectrum antibiotics, corticosteroids, and supportive care. The patient also developed acute kidney injury during treatment but eventually recovered and was discharged after a week.

Clinical discussion: The rapid onset of SJS in this patient reveals the unpredictable nature of drug-induced reactions. Early intervention with a multidisciplinary approach involving dermatology, intensive care, and infectious disease specialists was crucial in managing her condition. Despite the controversy surrounding corticosteroid use in SJS, their administration likely contributed to the rapid improvement in inflammation and skin healing. The case highlights the importance of early recognition, prompt management, and careful monitoring for adverse drug reactions, especially when prescribing medications known to cause SJS.

Conclusion: The successful outcome achieved through a multidisciplinary approach provides valuable insights into the effective strategies for handling severe drug reactions, emphasizing that early diagnosis and comprehensive management in patients with SJS is critical.

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来源期刊
Annals of Medicine and Surgery
Annals of Medicine and Surgery MEDICINE, GENERAL & INTERNAL-
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5.90%
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