Abstract
Mania with psychotic features is one of the common presenting clusters of psychiatric symptoms in HIV-infected patients. Commonly, patients with HIV-associated mania receive antiretroviral treatment, mood stabilisers and antipsychotics. This case of Stevens-Johnson syndrome highlights the dilemmas and complications that may arise when prescribing multiple medications in HIV-associated psychiatric disorders.
Highlights
Stevens-Johnson syndrome (SJS)/toxic epidermal necrolysis (TEN) comprises cutaneous adverse reactions ranging from mild erythematous macules to extensive epidermal detachment and mucous membrane erosion
Case reports have demonstrated adverse cutaneous reactions associated with the use of sodium valproate and risperidone.[5,6]
He developed Stevens-Johnson syndrome (SJS), which progressed to toxic epidermal necrolysis (TEN) and death over a period of 26 days
Summary
Z Zingela, MB ChB, MMed (Psych), FC Psych (SA); A Bronkhorst, MB ChB, DMH (SA); W M Qwesha, MB ChB; B P Magigaba, MB ChB, FC Derm (SA). [1] Mania is one of the most common psychiatric presentations in HIV-infected patients and requires antiretroviral therapy (ART), mood stabilisers and antipsychotics to increase patient quality of life and decrease mortality.[1,2,3] ART may protect from further cognitive deterioration and preserve functionality.[1] The link between systemic hypersensitivity reactions and nevirapine has been well documented.[4] Case reports have demonstrated adverse cutaneous reactions associated with the use of sodium valproate and risperidone.[5,6] This report describes the case of an HIV-seropositive patient who presented with mania for the first time and was treated with nevirapine, sodium valproate and risperidone He developed Stevens-Johnson syndrome (SJS), which progressed to toxic epidermal necrolysis (TEN) and death over a period of 26 days
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