Síndrome de Stevens-Johnson em pré-escolar em tratamento de pneumonia: relato de caso

Abstract

INTRODUCTION:Stevens-Johnson syndrome (SJS) is characterized by a severe skin reaction that can be triggered mainly by an allergic drug reaction. It is a potentially life threatening condition and has a worldwide incidence of 0.36 in 100.000. CASE REPORT: A 5-year-old, white, male patient presented bullous lesion on the upper lip and high fever, after a bacterial tonsillitis followed by pneumonia in which amoxicillin, amoxicillin-clavulanate, and ceftriaxone were administered sequentially. Oral mucosa lesions were disseminated and the patient was hospitalized with suspected pharmacoderma due to the use of antibiotics. Even after antibiotic replacement and antihistamines prescription, the patient developed an increased number of blisters on the labial, oral, nasal mucosa and in the tongue, also, there was an appearance of eyelid edema, cutaneous lesion in the auricular pavilion, and conjunctival, genital and perianal enanthem. The patient was admitted to the pediatric ICU and a skin lesion biopsy was performed, which showed extensive lower epidermal necrosis with inflammatory cell infiltrate, which confirmed the diagnostic suspicion of Stevens-Johnson syndrome. The treatment was performed using oral corticosteroids, prednisolone at a dose of 1mg/kg/day for 10 days, with gradual removal in 12 days and the use of cellulose membrane curative. CONCLUSION:The case addresses the probable correlation of Stevens-Johnson syndrome with amoxicillin use and presents the characteristic clinical manifestations of SJS, highlighting the importance of diagnostic suspicion and early treatment of this condition.