Risk factors and diagnostic markers of bacteremia in Stevens-Johnson syndrome and toxic epidermal necrolysis: A cohort study of 176 patients

Koh, Hui Kai; Chai, Zi Teng; Tay, Hui Wen; Fook‐Chong, Stephanie; Choo, Karen Jui Lin; Oh, Choon Chiat; Yeo, Yoomi; Koh, Hong Yi; Pang, Shiu Ming; Lee, Haur Yueh

doi:10.1016/j.jaad.2019.05.096

Cited by 27 publications

(11 citation statements)

References 29 publications

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“…Confusion, hypotension, reduced urinary output, and reduced oxygen saturation may indicate systemic infection. 106,110 In patients in whom infection is suspected, bacterial swabs should be obtained. Slow-healing sites with erosions or vesicles may indicate HSV super-infection, particularly in genital and oral sites; viral swabs should be obtained in such cases.…”

Section: Infection Surveillancementioning

confidence: 99%

Society of Dermatology Hospitalists supportive care guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults

Seminario‐Vidal

Kroshinsky

Malachowski

et al. 2020

Journal of the American Academy of Dermatology

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Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening conditions with high morbidity and mortality. Supportive care management of SJS/TEN is highly variable. A systematic review of the literature was performed by dermatologists, ophthalmologists, intensivists and gynecologists with expertise in SJS/TEN to generate statements for supportive care guideline development. Members of the Society of Dermatology Hospitalists (SDH) with expertise in SJS/TEN were invited to participate in a modified, online Delphi-consensus. 9-point Likert scale questionnaires regarding 135 statements were administered. The RAND/UCLA appropriateness method was employed to evaluate and select proposed statements for guideline inclusion; statements with median ratings of 6.5-9 and disagreement index ≤1 were included in the guideline. For the final round, the guidelines were appraised by all the participants. An evidence-based discussion and recommendations for hospital setting and care team, wound care, ocular care, oral care, urogenital care, pain management, infection surveillance, fluid and electrolyte management, nutrition and stress ulcer prophylaxis, airway management, and anticoagulation in adult patients with SJS/TEN are included.

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Section: Infection Surveillancementioning

confidence: 99%

Society of Dermatology Hospitalists supportive care guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults

Seminario‐Vidal

Kroshinsky

Malachowski

et al. 2020

Journal of the American Academy of Dermatology

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“…A retrospective research study reviewed 176 patients with TEN or SJS with the goal of recognizing the possible risk factors that would increase the likelihood of bacteremia. The study concluded that patients with a hemoglobin ≤10 g/dL, cardiovascular comorbidities as well as a body surface area ≥10% had a higher risk of developing subsequent bacteremia [11]. Contrary to popular beliefs, prophylactic antibiotics are not recommended despite the presence of risk factors for sepsis [12].…”

Section: Discussionmentioning

confidence: 98%

The Reflection on the Management of Toxic Epidermal Necrolysis in the Community Setting: An Internist's Perspective

Qian¹,

Shaikh²,

Yoon³

et al. 2021

Cureus

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Toxic epidermal necrolysis (TEN) is a dermatological emergency that is often associated with high mortality. It is differentiated from Stevens-Johnson syndrome (SJS) based on the percentage of the total body surface area affected. There has been an established correlation with certain medications that could trigger the development of such a devastating disease. Despite numerous research studies conducted on aspects of this disease entity, TEN remains foreign to many general Internists situated in a community setting due to the extremely low disease prevalence that leads to a lack of overall experience and medical resources in dealing with this medical condition. Thus, we outlined several important management aspects of TEN/SJS that an Internist should be aware of in order to assist in prompt clinical decision making and prognosis forecasting as well as deliver effective family communication.

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“…Dari penyaringan artikel didapatkan 2 artikel kohort yang sesuai dengan pertanyaan klinis dan kriteria eligibilitas (Gambar 1). 22 Karakteristik kedua artikel tersebut dapat dilihat pada Tabel 1.…”

Section: Hasilunclassified

Faktor Risiko Prediktor Bakteremia pada Pasien Nekrolisis Epidermal: Evidence-Based Case Report

Anindya¹,

Muhammad²,

Budianti³

2022

J. Kdokt Meditek

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Nekrolisis epidermal (NE) yang terbagi atas Sindrom Stevens-Johnson (SSJ) dan nekrolisis epidermal toksik (NET) merupakan reaksi simpang obat berat dengan mortalitas tinggi. Penyebab kematian terbanyak pada NE adalah sepsis, namun gejala sepsis tidak spesifik pada NE dan hasil kultur darah membutuhkan waktu lama. Oleh karena itu penting mengetahui prediktor yang berpengaruh terhadap peningkatan risiko bakteremia pada pasien dengan NE. Evidence-based case report ini bertujuan mengetahui faktor prediktor terjadinya bakteremia pada pasien NE berdasarkan literatur. Pencarian artikel menggunakan basis data PubMed, Cochrane, dan Scopus yang relevan dengan pertanyaan klinis untuk kemudian ditelaah. Didapatkan dua artikel kohort yang sesuai. Studi Koh dkk. mendapatkan tiga prediktor yang berpengaruh terhadap kejadian bakteremia pada pasien NE; yaitu hemoglobin ≤ 10 g/dL (odds ratio [OR] 2,4; interval kepercayaan [IK] 95% 2,2-2,6), luas epidermolisis ≥ 10% (OR 14,3; IK 95% 13,4-15,2) dan penyakit komorbid kardiovaskular (OR 2,1; IK 95% 2,0-2,3). Studi De Prost dkk. mendapatkan tiga prediktor yaitu usia > 40 tahun (hazard ratio [HR] 2,5; IK 95% 1,35-4,63), leukosit > 10.000/mm3 (HR 1,9; IK 95% 0,96-3,61), serta LPB ≥ 30% (HR 2,5; IK 95% 1,13-5,47). Epidermolisis yang lebih luas merupakan faktor prediktor terjadinya bakteremia pada NE di kedua studi. Faktor risiko lainnya memerlukan penelitian lebih lanjut.

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Risk factors and diagnostic markers of bacteremia in Stevens-Johnson syndrome and toxic epidermal necrolysis: A cohort study of 176 patients

Cited by 27 publications

References 29 publications

Society of Dermatology Hospitalists supportive care guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults

Society of Dermatology Hospitalists supportive care guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults

The Reflection on the Management of Toxic Epidermal Necrolysis in the Community Setting: An Internist's Perspective

Faktor Risiko Prediktor Bakteremia pada Pasien Nekrolisis Epidermal: Evidence-Based Case Report

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