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Toxic epidermal necrolysis after topical intranasal application of mupirocin

Sophie-Maria Praz1, Antoine de Torrenté, Hervé Zender

  • 1Department of Internal Medicine, Hôpital de la ville, La Chaux-de-Fonds, Switzerland.

Infection Control and Hospital Epidemiology
|June 28, 2003
PubMed

Insights

Toxic epidermal necrolysis, a severe skin reaction, occurred after intranasal mupirocin use. This case highlights potential risks associated with topical antibiotics for methicillin-resistant Staphylococcus aureus eradication.

Area of Science:

  • Dermatology
  • Infectious Diseases
  • Pharmacology

Background:

  • Methicillin-resistant Staphylococcus aureus (MRSA) poses a significant public health threat, necessitating effective eradication strategies.
  • Intranasal mupirocin is commonly used for MRSA decolonization.
  • Severe cutaneous adverse drug reactions (SCARs) are rare but serious complications of pharmacotherapy.

Observation:

  • A 76-year-old woman developed toxic epidermal necrolysis (TEN).
  • The patient had recently received intranasal mupirocin.
  • The indication for mupirocin was MRSA eradication.

Findings:

  • This case presents a potential link between intranasal mupirocin application and the development of TEN.
  • The temporal association suggests mupirocin as a possible causative agent.

Implications:

  • Clinicians should be vigilant for severe skin reactions following intranasal mupirocin use.
  • Further investigation into the safety profile of intranasal mupirocin, particularly in elderly patients, may be warranted.
  • Alternative MRSA decolonization strategies might be considered in patients with a history of severe cutaneous reactions.

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