A Rare Case of Toxic Epidermal Necrolysis with Unexpected Fever Resulting from Dengue Virus

Abstract

Toxic epidermal necrolysis (TEN), also known as Lyell’s syndrome, is a life-threatening disease with common development of large wounds. Thus, affected patients are usually treated in specialized centers. Herein, we present a case of TEN in a patient infected with human immunodeficiency virus with the additional, unexpected diagnosis of dengue fever. In this context, we discuss cause, diagnosis, pathology, and treatment of TEN and highlight the role of rare and unexpected findings, as in this case an additional tropical virus infection. We underpin the importance of an interdisciplinary approach involving dermatologists, ophthalmologists, intensive care physicians, burn specialists and various other departments and emphasize the challenge of TEN treatment, especially if rare pathological findings occur.

Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

“…Several microorganisms are considered to be the cause of SJS/TEN. For example, SJS/TEN can occur after vaccination with chickenpox, measles [8], Mycoplasma pneumonia [9], dengue virus [10], it is also associated with cytomegalovirus reactivation [11], currently, SJS may be related with Covid 19 [12] or Covid 19 vaccination [13,14]. Other causes include serum injection, host graft rejection [15].…”

Drug induced exfoliative dermatitis: state of the art

“…Drugs such as paracetamol, other non-oxicam NSAIDs and furosemide, bringing a relatively low risk of SJS/TEN a priori, are also highly prevalent as putative culprit agents in large SJS/TEN registries, due to their widespread use in the general population [ 63 , 64 ] (Table 1 ). Rarely, Mycoplasma pneumoniae , dengue virus, cytomegalovirus, and contrast media may be the causative agent of SJS and TEN [ 22 , 65 – 67 ].…”