Case Report: Stevens–Johnson syndrome/toxic epidermal necrolysis overlap with ocular and urogenital involvement in an extremely preterm infant following broad-spectrum antibiotic exposure - Report - MDSpire
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Case Report: Stevens–Johnson syndrome/toxic epidermal necrolysis overlap with ocular and urogenital involvement in an extremely preterm infant following broad-spectrum antibiotic exposure
Clinical Case: Overlap of Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis
Background
SJS/TEN are rare but severe skin reactions characterized by extensive epidermal necrosis and mucosal involvement. In neonates, particularly those who are extremely premature, diagnosis is complicated by the presence of other common skin conditions in the NICU. There is a lack of structured guidelines for managing SJS/TEN in this vulnerable population, making awareness and early recognition critical. Recent studies indicate that the incidence of SJS/TEN in neonates is significantly lower than in older children, and the management of these cases remains poorly defined in the literature.
Data Highlights
No numerical data or trial data available in the article.
Key Findings
The infant was born at 23 + 5 weeks’ gestation and developed SJS/TEN overlap at a corrected age of 35 + 3 weeks.
Progressive mucocutaneous erosions began periorally and spread to the trunk, extremities, and genitals.
Epidermal detachment was estimated at 25–30% body surface area, consistent with SJS/TEN overlap.
Skin biopsy confirmed full-thickness keratinocyte necrosis with sub-epidermal blistering.
The infant died from septic shock and multi-organ failure related to extreme prematurity and recurrent necrotizing enterocolitis.
Clinical Implications
This case highlights the diagnostic complexity of SJS/TEN in extremely premature infants exposed to broad-spectrum antibiotics.
