Ciprofloxacin-induced toxic epidermal necrolysis: a case report

Toxic epidermal necrolysis (TEN) is an uncommon fulminating mucocutaneous disease associated with marked morbidity and mortality. While sometimes idiopathic, TEN is frequently associated with drug administration. We report a well-documented fatal case of ciprofloxacin-induced TEN in a 50-year-old man treated for a bacterial infection of lower extremity venous stasis ulcers. To our knowledge, a total of 6 cases have been reported in the literature documenting an association between oral ciprofloxacin administration and TEN or Stevens-Johnson syndrome. The patient in this case had no prior medical conditions known to cause TEN, was not being treated with any medication other than ciprofloxacin (500 mg b.i.d.) and developed the clinical symptoms of TEN in a time course compatible with drug-induced TEN. This case provides strong evidence for the culpability of ciprofloxacin in the development of TEN.