Stevens-Johnson Syndrome

Dangerous

Step 1: View clinicals

A 65 year old African-American lady presents with fever, bilateral red eyes, ulcers of the lips and mouth, and a widespread erythematous rash for 2 days, which has rapidly expanded over time. Close questioning reveals that she started self-medicating herself with Ibuprofen around 2 weeks ago, due to pain in her right knee joint while walking. Her medical history is otherwise unremarkable. She has had a single stable sexual partner for the last 5 years. There is no history of recent foreign travel.


Step 2: Order all relevant investigations

Full Blood Count

WBC/DC: 5,000/mm3 (4,600 - 11,000) Hb: 12.6 g/dL (11.5 - 18.5) Hct (PCV): 34% Platelets: 250,000/mm3 (150,000-400,000)

Skin + Mouth Swab Cultures

Culture results will be available in 3 days.

Skin Biopsy

The skin biopsy results will be available tomorrow.

Urea, Glucose, Bicarbonate

Random Blood Glucose, Blood Urea, Serum Bicarbonate: Within normal limits


Step 3: Select appropriate management

Ophthalmology Referral
Corticosteroids
IV Antibiotics
Referral to Burns Unit


Score: ★★☆