Login Register Cart 0
Generic placeholder image

Current Drug Safety

Editor-in-Chief

ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Case Report

A Case Report of Cefixime, Paracetamol, and Nimesulide Induced Toxic Epidermal Necrolysis in a Woman with Dengue Infection without any Other Associated Comorbidities

Author(s): Renuka Munshi* and Miteshkumar Maurya

Volume 19, Issue 2, 2024

Published on: 04 May, 2023

Page: [286 - 290] Pages: 5

DOI: 10.2174/1574886318666230418104445

Price: $65

Abstract

Background: Toxic Epidermal Necrolysis (TEN) is a rare, acute, and life-threatening mucocutaneous disease that occurs after the administration of certain drugs, resulting in extensive keratinocyte cell death, skin involvement at the dermal-epidermal junction, and extensive bullous skin eruptions and sloughing. Many published case reports have observed the presence of fever with a viral infection, drug, and/or genetic association as a possible trigger for TEN but associated with other comorbidities. Physicians still struggle to predict which individuals could be predisposed to TEN. The case report that we present had a history of multiple drug intake and fever due to dengue virus infection but was not associated with any other comorbidity.

Case Presentation: We present an unusual case of a 32-year-old woman of Western Indian origin who had developed dengue infection and suffered toxic epidermal necrolysis following a five-day course of a third-generation cephalosporin antibiotic, cefixime and a three-day course of 2 analgesic drugs, paracetamol (acetaminophen), and nimesulide, with the adverse event occurring on the fifth day of the dengue infection. The offending drugs were stopped, and patient survived with supportive management and hydration.

Conclusion: The presence of comorbidities may not always be the triggering factor for TEN, though it can affect patient outcomes. Rational drug use is always recommended for patient care. Further research is required to understand the pathomechanism behind the viral-drug-gene interaction.

« Previous Next »
[1]
Lyell A. Toxic epidermal necrolysis: An eruption resembling scalding of the skin. Br J Dermatol 1956; 68(11): 355-61.
[http://dx.doi.org/10.1111/j.1365-2133.1956.tb12766.x] [PMID: 13374196]
[2]
Rzany B, Correia O, Kelly JP, Naldi L, Auquier A, Stern R. Risk of Stevens-Johnson syndrome and toxic epider mal necrolysis during first weeks of antiepileptic therapy: A case-control study. Lancet 1999; 353(9171): 2190-4.
[http://dx.doi.org/10.1016/S0140-6736(98)05418-X] [PMID: 10392983]
[3]
La Grenade L, Lee L, Weaver J, et al. Comparison of reporting of Stevens-Johnson syndrome and toxic epidermal necrolysis in association with selective COX-2 inhibitors. Drug Saf 2005; 28(10): 917-24.
[http://dx.doi.org/10.2165/00002018-200528100-00008] [PMID: 16180941]
[4]
Achten G, Ledoux-Corbusier M. Toxic epidermal necrolysis de Lyell: Aspects histologiques. Arch Belg Dermatol Syphiligr 1970; 26(2): 97-114.
[PMID: 5515557]
[5]
French LE. Toxic epidermal necrolysis and Stevens Johnson syndrome: Our current understanding. Allergol Int 2006; 55(1): 9-16.
[http://dx.doi.org/10.2332/allergolint.55.9] [PMID: 17075281]
[6]
Ban GY, Ahn SJ, Yoo HS, Park HS, Ye YM. Stevens–Johnson syndrome and toxic epidermal necrolysis associated with acetaminophen use during viral infections. Immune Netw 2016; 16(4): 256-60.
[http://dx.doi.org/10.4110/in.2016.16.4.256] [PMID: 27574505]
[7]
Grieb G, Alazemi M, Das R, Dunda SE, Fuchs PC, Pallua N. A rare case of toxic epidermal necrolysis with unexpected Fever resulting from dengue virus. Case Rep Dermatol 2010; 2(3): 189-94.
[http://dx.doi.org/10.1159/000322963] [PMID: 21509201]
[8]
Torres MJ, Mayorga C, Blanca M. Nonimmediate allergic reactions induced by drugs: Pathogenesis and diagnostic tests. J Investig Allergol Clin Immunol 2009; 19(2): 80-90.
[PMID: 19476012]
[9]
Abe R. Immunological response in Stevens-Johnson syndrome and toxic epidermal necrolysis. J Dermatol 2015; 42(1): 42-8.
[http://dx.doi.org/10.1111/1346-8138.12674] [PMID: 25355273]
[10]
Fouchard N, Bertocchi M, Roujeau J-C, Revuz J, Wolkenstein P, Bastuji-Garin S. SCORTEN: a severity-of-illness score for toxic epidermal necrolysis. J Invest Dermatol 2000; 115(2): 149-53.
[http://dx.doi.org/10.1046/j.1523-1747.2000.00061.x] [PMID: 10951229]
[11]
Sassolas B, Haddad C, Mockenhaupt M, et al. ALDEN, an algorithm for assessment of drug causality in Stevens-Johnson Syndrome and toxic epidermal necrolysis: comparison with case-control analysis. Clin Pharmacol Ther 2010; 88(1): 60-8.
[http://dx.doi.org/10.1038/clpt.2009.252] [PMID: 20375998]
[12]
Rajaram Maurya M, Munshi R, Bhausaheb Zambare S, Thakur S. Perspective chapter: Drug-induced severe cutaneous Adverse Reactions, diagnostics and management. In: Tyagi RK, Sharma P, Sharma P, Eds. Immunosuppression and Immunomodulation. London, England: IntechOpen 2023.
[http://dx.doi.org/10.5772/intechopen.108651]
[13]
French LE, Prins C. Prins C: Erythema multiforme, stevens-johnson syndrome and toxic epidermal necrolysis. In: Bolognia JL, Jorrizo JL, Schaffer JV, Eds. Dermatology. (3rd edition.). Elsevier New York 2013; pp. 319-33.
[14]
Babu T, Panachiyil GM, Vasudev PH, Ravi MD. A rare pediatric case of cefixime induced toxic epidermal necrolysis. Hosp Pharm 2022; 57(2): 237-40.
[http://dx.doi.org/10.1177/00185787211016332] [PMID: 35601719]
[15]
Schöpf E, Stühmer A, Rzany B, Victor N, Zentgraf R, Kapp JF. Toxic epidermal necrolysis and Stevens-Johnson syndrome. An epidemiologic study from West Germany. Arch Dermatol 1991; 127(6): 839-42.
[http://dx.doi.org/10.1001/archderm.1991.01680050083008] [PMID: 2036029]
[16]
Boroda K, Li L, Riina L, Ahmed S. Cephalosporin-induced toxic epidermal necrolysis treated with intravenous immunoglobulin. Cureus 2015; 7(10): e359.
[http://dx.doi.org/10.7759/cureus.359] [PMID: 26623214]
[17]
Bygum A, Gregersen JW, Buus SK. Acetaminophen-induced toxic epidermal necrolysis in a child. Pediatr Dermatol 2004; 21(3): 236-8.
[http://dx.doi.org/10.1111/j.0736-8046.2004.21309.x] [PMID: 15165202]
[18]
Halevi A, Ben-Amitai D, Garty BZ. Toxic epidermal necrolysis associated with acetaminophen ingestion. Ann Pharmacother 2000; 34(1): 32-4.
[http://dx.doi.org/10.1345/aph.19064] [PMID: 10669183]
[19]
Dias E, Rai V. Three years old child with toxic epidermal necrolysis due to paracetamol tablet ingestion. Inter J Health Sci Pharma [IJHSP] 2017; 1(2): 68-71.
[http://dx.doi.org/ 10.47992/IJHSP.2581.6411.0019]
[20]
Xaviar S, Ravichandran M. A case of nimesulide induced toxic epidermal necrolysis. Int J Basic Clin Pharmacol 2020; 9(5): 810-2.
[http://dx.doi.org/10.18203/2319-2003.ijbcp20201764]
[21]
Chatterjee S, Pal J, Biswas N. Nimesulide-induced hepatitis and toxic epidermal necrolysis. J Postgrad Med 2008; 54(2): 150-1.
[http://dx.doi.org/10.4103/0022-3859.40786] [PMID: 18480536]
[22]
Kumar V, et al. Nimesulide induced toxic epidermal necrolysis: A rare case report. Inter J Basic Clin Pharmacol 2017; 6(12): 2939-42.
[http://dx.doi.org/10.18203/2319-2003.ijbcp20175223]
[23]
Pena MÁ, Pérez S, Zazo MC, et al. A case of toxic epidermal necrolysis secondary to acetaminophen in a child. Curr Drug Saf 2016; 11(1): 99-101.
[http://dx.doi.org/10.2174/1574886310666150921103852] [PMID: 26391426]
[24]
Gupta MC, Mittal N. Toxic epidermal necrolysis induced by acetaminophen: A case report. Inter J Basic Clin Pharmacol 2017; 2(6): 831-2.
[25]
Sheridan RL, Weber JM, Schulz JT, Ryan CM, Low HM, Tompkins RG. Management of severe toxic epidermal necrolysis in children. J Burn Care Rehabil 1999; 20(6): 497-500.
[http://dx.doi.org/10.1097/00004630-199920060-00012] [PMID: 10613688]
[26]
Lipovy B, Holoubek J, Hanslianova M, et al. Impact of antibiotics associated with the development of toxic epidermal necrolysis on early and late-onset infectious complications. Microorganisms 2021; 9(1): 202.
[http://dx.doi.org/10.3390/microorganisms9010202] [PMID: 33477980]
[27]
Pejcic AV, Milosavljevic MN, Folic M, et al. Amoxicillin-associated Stevens-Johnson syndrome or toxic epidermal necrolysis: Systematic review. J Chemother 2022; 2022: 1-12.
[http://dx.doi.org/10.1080/1120009X.2022.2051128] [PMID: 35285784]
[28]
Yoo HW, Kim HY, Shin K, Kim SH. Clinical characteristics of drug-induced Stevens-Johnson syndrome and toxic epidermal necrolysis: A single-center study. Asia Pac Allergy 2022; 12(2): e17.
[http://dx.doi.org/10.5415/apallergy.2022.12.e17] [PMID: 35571552]
[29]
Diao M, Thapa C, Ran X, Ran Y, Lv X. A retrospective analysis of infections and antibiotic treatment in patients with Stevens–Johnson syndrome and toxic epidermal necrolysis. J Dermatolog Treat 2020; 31(1): 61-5.
[http://dx.doi.org/10.1080/09546634.2018.1509047] [PMID: 30095319]
[30]
Frantz R, Huang S, Are A, Motaparthi K. Stevens–Johnson syndrome and toxic epidermal necrolysis: A review of diagnosis and management. Medicina 2021; 57(9): 895.
[http://dx.doi.org/10.3390/medicina57090895] [PMID: 34577817]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy