Fatal pediatric Stevens–Johnson syndrome/toxic epidermal necrolysis: Three case reports. Issue 12 (March 2020)

• Record Type: Journal Article
• Authors: Shi, Tingting; Chen, Huan; Huang, Li; Fan, Huifeng; Yang, Diyuan; Zhang, Dongwei; Lu, Gen
• Other Names: NA. section editor.
• Is Part Of: Medicine. Volume 99:Issue 12(2020)
• Publication Date: 2020-03
• Subjects: children -- severe complications -- Stevens–Johnson syndrome -- toxic epidermal necrolysis; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000019431
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract: Rationale: Stevens–Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) are extremely rare but potentially life-threatening disorders. We presented 3 fatal pediatric SJS/TEN cases. Patient concerns: Our patients had some severe complications such as septic shock, respiratory failure and obliterans bronchiolitis (BO) etc. Diagnosis: Three patients diagnosed SJS/TEN with clinical symptoms that were triggered by antibiotics, nonsteroidal anti-inflammatory drugs, previous infection, or neoplasms. Interventions: All of them accepted mechanical ventilation, intravenous immunoglobulin (IVIG), blood transfusion, glucocorticoid, and multi-anti-infectious therapy. Outcomes: They all died because of out-of-control severe infections. In Patient 1, he died 6 days after being admitted to the PICU on the 28th day from onset. In Patient 2, he died on the 211th day from the onset of illness during the third time of PICU admission. In Patient 3, she died 12 days after PICU admission on the 87th day from onset. Lessons: We should be aware that mucosal damage occurs on the skin and within the mucosa of visceral organs, leading to the occurrence of bronchiectasia, BO, enterocolitis, acute renal failure, and severe secondary infections. Establish a clinically predictive score that includes severe infection for pediatric patients to evaluate the risk of mortality in children in order to improve poor outcomes.