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Pneumonia caused by toxic epidermal necrolysis
Dominic Doyle1, Amy Long1, Desmond M Murphy1
1The Department of Respiratory Medicine Cork University Hospital Cork Ireland.
Respirology Case Reports
|October 7, 2022
Summary
A rare Ciprofloxacin drug reaction caused Toxic Epidermal Necrolysis (TEN), leading to severe skin and lung complications. This case highlights chronic pulmonary issues as a potential long-term consequence of TEN.
Area of Science:
- Dermatology
- Pulmonology
- Pharmacology
Background:
- Toxic Epidermal Necrolysis (TEN) is a severe, life-threatening mucocutaneous reaction.
- Drug-induced TEN is rare but carries significant morbidity and mortality.
- Ciprofloxacin is an antibiotic with a known, albeit infrequent, association with severe cutaneous adverse reactions.
Observation:
- A 68-year-old male developed a macular rash 2 weeks after initiating Ciprofloxacin.
- The rash rapidly progressed to involve skin and mucosa, accompanied by pancytopenia.
- Pulmonary infiltrates, dysphagia, and recurrent aspiration pneumonias were noted.
Findings:
- Skin biopsy confirmed Toxic Epidermal Necrolysis (TEN).
- Lymphocyte transformation test indicated Ciprofloxacin sensitization.
- Computed tomography revealed fixed airways obstruction and bronchiolitis, suggesting chronic pulmonary sequelae.
Implications:
- This case underscores Ciprofloxacin as a potential trigger for TEN.
- It highlights the potential for chronic pulmonary complications following TEN.
- Early recognition and management of drug-induced TEN are crucial to mitigate severe outcomes.
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