Amoxycillin and clavulanic acid-induced Stevens-Johnson Syndrome in a dialysis patient

Abstract

A 48-year-old male patient with chronic kidney disease on haemodialysis came with complaints of worsening fever comprising maculopapular rashes and was diagnosed with Stevens-Johnson Syndrome- Toxic Epidermal Necrolysis (SJS-TEN) with sepsis (probably catheter-associated). The patient developed rashes with skin eruptions over the abdomen, trunk, around hands, face with redness and swelling on both legs following intake of Augmentin (containing amoxicillin and clavulanic acid). His management was done with IV steroids, antibiotics and supportive treatment. Stevens-Johnson syndrome (SJS) is an immune-mediated delayed hypersensitivity reaction with a severe form of cutaneous reactions involving areas of the face, genitals and mucous membrane of GI tract and respiratory tract. These manifestations occur as a result of certain drugs or due to any infection. In 95 % of the reported cases, drugs, including penicillin, was found to be a cause. In this case, report the patient had SJS with TEN comprising >30% of body surface area (BSA).