Steven Johnson Syndrome Case Studies
Steven-Johnson Syndrome: Pathogenesis, Diagnosis, and Management
Traci Segar
Winona State University
Steven-Johnson Syndrome: Pathogenesis, Diagnosis, and Management
In 1976 I was diagnosed with Steven-Johnson Syndrome. I was two weeks shy of my third birthday. I developed a sore throat and was given my first penicillin injection. My parents tell me that, several days later, I spiked a fever and complained that my arms and legs hurt. I was refusing to move and didn’t want to eat anything so my parents took me back to the doctor. I had swollen joints and blistered areas noted in my mouth. I was admitted to the local hospital with a tentative diagnosis of measles. By the next day I had blisters and sloughing tissue in my mouth, genitals, …show more content…
SJS occurs with a worldwide distribution similar in etiology and occurrence to that in the United States. Cases tend to have a propensity for the early spring and winter (Foster, 2011). Stevens-Johnson syndrome has been described worldwide in all races, although it may be more common in whites. Interestingly, disease is not limited to humans; cases have been reported in dogs, cats, and monkeys (Strom & Carson, 1991). The proportion of females has been estimated to be 33-62%. The mean age of patients with Stevens-Johnson syndrome is 38 years, but cases have been reported in children as young as 3 months (Foster …show more content…
At some centers wounds are surgically debrided and whirlpool therapy is used to remove necrotic tissue (Foster, 2011). In contrast, other centers use “antishear” wound care, in which the detached skin is left in place to serve as a bandage, potentially reducing painful debridement (Foster, 2011). These two approaches were found to result in equivalent rates of survival and reepithelialization (Foster, 2011). Fluid and electrolyte imbalances may occur due to increased transepidermal water loss. Room temperature should be increased to 30-32 degrees Celsius, and/or the use of heated air body warmers to prevent excessive caloric expenditures due to epidermal loss (High & Nirken, 2012). Oral feedings, via a nasogastric tube if necessary, should be started early. Passage of a nasogastric tube should be done with great care to minimize damage to affected mucous
Traci Segar
Winona State University
Steven-Johnson Syndrome: Pathogenesis, Diagnosis, and Management
In 1976 I was diagnosed with Steven-Johnson Syndrome. I was two weeks shy of my third birthday. I developed a sore throat and was given my first penicillin injection. My parents tell me that, several days later, I spiked a fever and complained that my arms and legs hurt. I was refusing to move and didn’t want to eat anything so my parents took me back to the doctor. I had swollen joints and blistered areas noted in my mouth. I was admitted to the local hospital with a tentative diagnosis of measles. By the next day I had blisters and sloughing tissue in my mouth, genitals, …show more content…
SJS occurs with a worldwide distribution similar in etiology and occurrence to that in the United States. Cases tend to have a propensity for the early spring and winter (Foster, 2011). Stevens-Johnson syndrome has been described worldwide in all races, although it may be more common in whites. Interestingly, disease is not limited to humans; cases have been reported in dogs, cats, and monkeys (Strom & Carson, 1991). The proportion of females has been estimated to be 33-62%. The mean age of patients with Stevens-Johnson syndrome is 38 years, but cases have been reported in children as young as 3 months (Foster …show more content…
At some centers wounds are surgically debrided and whirlpool therapy is used to remove necrotic tissue (Foster, 2011). In contrast, other centers use “antishear” wound care, in which the detached skin is left in place to serve as a bandage, potentially reducing painful debridement (Foster, 2011). These two approaches were found to result in equivalent rates of survival and reepithelialization (Foster, 2011). Fluid and electrolyte imbalances may occur due to increased transepidermal water loss. Room temperature should be increased to 30-32 degrees Celsius, and/or the use of heated air body warmers to prevent excessive caloric expenditures due to epidermal loss (High & Nirken, 2012). Oral feedings, via a nasogastric tube if necessary, should be started early. Passage of a nasogastric tube should be done with great care to minimize damage to affected mucous