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[Lethal Lyell's syndrome induced by fusidic acid]
C Cluzel1, P Pralong1, S Logerot2
1Clinique universitaire de dermatologie, allergologie et photobiologie, CHU de Grenoble, boulevard de la Chantourne, CS10217, 38043 Grenoble cedex 9, France.
Annales De Dermatologie Et De Venereologie
|February 3, 2016
Summary
This case report details the first fatal instance of toxic epidermal necrolysis (TEN) caused by oral fusidic acid. It highlights the severe risks associated with this rare but serious adverse drug reaction.
Area of Science:
- Dermatology
- Pharmacovigilance
- Toxicology
Background:
- Fusidic acid is a topical antibiotic frequently used for staphylococcal infections.
- Oral fusidic acid is rarely prescribed, typically for bone or joint infections.
Observation:
- An 82-year-old woman developed a severe generalized bullous skin eruption with epidermal detachment.
- She presented with fever, oral/ocular ulcerations, and a positive Nikolsky sign, consistent with Lyell's syndrome (toxic epidermal necrolysis).
- The patient had been prescribed oral fusidic acid 12 days prior for a sacral pressure sore.
Findings:
- Histopathology confirmed total epidermal necrosis.
- The patient experienced a fatal outcome within 24 hours of diagnosis.
- This represents the first reported case of fatal toxic epidermal necrolysis linked to oral fusidic acid.
Implications:
- Fusidic acid should be recognized as a potential cause of severe cutaneous adverse reactions, including toxic epidermal necrolysis.
- Healthcare providers should exercise caution when prescribing oral fusidic acid due to its potential for serious adverse events.