Toxic epidermal necrolysis data from the CELESTE multinational registry. Part I: Epidemiology and general microbiological characteristics

Incidence of bloodstream infections and predictive value of qualitative and quantitative skin cultures of patients with overlap syndrome or toxic epidermal necrolysis: A retrospective observational cohort study of 98 cases

“…The NPV of the concomitant skin cultures were high for S. aureus and P. aeruginosa, illustrating that patients with negative skin cultures for these pathogens were unlikely to have a BSI involving these pathogens. We also showed the importance of monitoring skin cultures over time, as we observed a switch of skin colonization from grampositive cocci at baseline to gram-negative bacilli during the hospital stay, as previously described for burn patients, [5][6][7]10 together with a significant decrease in the susceptibility patterns of the studied bacteria.…”

“…3 Causes of mortality in EN include specific lung involvement 4 and invasive bacterial infections, the most frequent and life-threatening being bloodstream infections (BSI). A relationship between BSI and skin bacterial colonization was described in burns, 5,6 but data from EN remain scarce. Here, we aimed to investigate the epidemiology of BSI in EN and assess the ability of the qualitative and quantitative results of skin cultures to predict the pathogen(s) involved in BSI episodes.…”

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

“…Infections have been reported in up to 85% of patients with SJS/TEN, 105 and sepsis is the most common cause of death. [106][107][108][109] Exposed dermis facilitates bacterial colonization, leading to increased infection risk and impaired re-epithelialization.…”

Responsiveness to i.v. immunoglobulin therapy in patients with toxic epidermal necrolysis: A novel pharmaco‐immunogenetic concept

“…Where delayed reactions occur, TEN patients have a higher risk of developing acute renal failure (particularly when sepsis and capillary-leak syndrome develop and in cases with insufficient fluid resuscitation), and a higher risk of pulmonary complications (including infections in the lower respiratory tract), depending on the severity of the endothelial damage. 82,83 Such patients can be also more susceptible to the development of thromboembolic complications. IVIg administration significantly increases these risks, which should be taken into account and a prophylaxis protocol for reduction of the incidence of these complications in TEN patients should be employed (e.g.…”

“…fever, tachycardia, hypotension or skin rash). Where delayed reactions occur, TEN patients have a higher risk of developing acute renal failure (particularly when sepsis and capillary‐leak syndrome develop and in cases with insufficient fluid resuscitation), and a higher risk of pulmonary complications (including infections in the lower respiratory tract), depending on the severity of the endothelial damage 82,83 . Such patients can be also more susceptible to the development of thromboembolic complications.…”