Синдром Стивенса — Джонсона как острая тяжелая аллергическая реакция у ребенка

Abstract

Stevens — Johnson syndrome is a rare severe acute systemic allergic reaction. Most often, this reaction is induced in children by an exposure to pathogenic microorganisms and intake of medications, mainly occurring with damage to the skin and mucous membranes of at least two organs. Despite the fact that the disease is rare in pediatric practice, its relevance is due not only to the fact that children with Stevens-Johnson syndrome have a sharply increased risk of complications and death, but also to the fact that today there are no universal regulatory algorithms and standards for the management of such patients. The diagnosis verification is based on the clinical symptoms of the disease and a competently collected anamnesis. Unfortunately, the current polypragmasia, as well as the difficulties of differentiating between the symptoms manifested in Stevens-Johnson syndrome, which are often regarded by doctors as the debut of an acute respiratory disease, complicates the interpretation of the disease inducer and leads to a late diagnosis, which in turn delays the elimination of allergen and therapy, eventually affecting the course and outcome of pathology. The article describes a clinical case in a patient with first-time Stevens — Johnson syndrome in response to the combined effects of such etiological factors as primary cytomegalovirus infection and drug administration. The patient was managed in a hospital setting with differential diagnosis and the appointment of intensive and rational therapy, which led to a favorable outcome of the disease.