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

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.