Pharmacology · patient case question
Stevens-Johnson syndrome is most often related to:
Patient case: Choosing and stopping drugs
demo: Series of prescribing decisions
chief: Several patients seen in one session raise questions about antibiotic choice, analgesia and anticoagulation.
history: One patient has a spreading odontogenic infection unresponsive to five days of empirical antibiotics. Another takes rivaroxaban for atrial fibrillation. A third developed a widespread blistering rash and mucosal ulceration a week after starting a new medication.
meds: Varies by patient.
findings: Not applicable.
Show answer and explanation
Correct answer: A. An adverse drug reaction
- A. Correct. Stevens-Johnson syndrome is a severe mucocutaneous hypersensitivity reaction, most often triggered by drugs: sulfonamides, anticonvulsants such as carbamazepine and lamotrigine, allopurinol and NSAIDs are the usual culprits. Target lesions, extensive mucosal ulceration and epidermal detachment define it, and it is a medical emergency.
- B. Mycoplasma pneumoniae infection can trigger a related reaction, particularly in children, but drugs are the dominant cause overall.
- C. Nutritional deficiency causes glossitis and angular cheilitis, not epidermal necrolysis.
- D. Autoimmune connective tissue disease causes other mucosal patterns; SJS is a hypersensitivity reaction, not a connective tissue disorder.