Critical Care and Shock

Toxic epidermal necrolysis

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The case
A 36-year-old lady presented with history of intermittent high-grade fever for the last 5 days. There was also history of yellowish discolouration of skin and sclera for the last 3 days, generalized body swelling and hemorrhagic rashes all over the body for the last 1 day. On further probing it was found that she had received an unknown intravenous antibiotic 2 days back from a local physician. She was intubated and mechanically ventilated as she became hypoxic due to airway edema. Other supportive measures were administered. The skin lesions initially presented as erythematous rashes, which over the next few days progressed, to urticarial plaques, bullae, followed by epidermal sloughing. A diagnosis of toxic epidermal necrolysis secondary to idiosyncratic drug reaction was made.

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