ABSTRACT
Objetivo: Relatar a assistência de enfermagem diante do caso de um adolescente com diagnóstico de Necrólise Epidérmica Tóxica (NET) internado em uma Unidade de Terapia Intensiva de Queimados. Método: Trata-se de um relato de caso sobre as intervenções de enfermagem realizadas em um adolescente com diagnóstico de NET, internado por um mês em 2020 na Unidade de Terapia Intensiva de Queimados de Goiás. As informações foram coletadas do prontuário do paciente. Resultados: Apresentamos práticas clínicas para auxiliar no manejo de pacientes com NET. O caso apresentado teve um desfecho positivo. Conclusão: Os cuidados de enfermagem são essenciais para o prognóstico positivo do paciente. Nesse caso, a enfermagem atuava principalmente no cuidado de feridas, administração de medicamentos, laserterapia e vigilância para prevenção de infecções
Objective: To report nursing care facing a case of an adolescent diagnosed with Toxic Epidermal Necrolysis (TEN) hospitalized in a Burns Intensive Care Unit. Method: This is a case report on the nursing interventions performed on a teenager diagnosed with TEN, who was hospitalized for a month in 2020 at the Burn Intensive Care Unit in the state of Goiás. The information was collected from the patient's medical record. Results: We present clinical practices to assist the management of patients with TEN. The case presented had a positive outcome. Conclusion: Nursing care is essential for the positive prognosis of the patient. In this case, nursing acted mainly in wound care, medication administration, laser therapy and surveillance to prevent infections
Objetivo: Informar los cuidados de enfermería en el caso de un adolescente diagnosticado de Necrólisis Epidérmica Tóxica (TNE) ingresado en una Unidad de Cuidados Intensivos por Quemados. Método: Se trata de un relato de caso sobre las intervenciones de enfermería prestadas a un adolescente diagnosticado de TNE, hospitalizado durante un mes en 2020 en la Unidad de Cuidados Intensivos Quemados de Goiás, información obtenida de la história clínica del paciente. Resultados: Presentamos prácticas clínicas para ayudar en el manejo de pacientes con TNE. El caso presentado tuvo un resultado positivo. Conclusión: El cuidado de enfermería es fundamental para el pronóstico positivo del paciente. En este caso, la enfermería trabajó principalmente en el cuidado de heridas, administración de medicamentos, terapia con láser y vigilancia para prevenir infecciones.
Subject(s)
Humans , Skin , Necrosis , Nursing Care , Wounds and Injuries , Burns , Adolescent , Toxicity , LasersABSTRACT
Introduction: Steven-Johnson syndrome and Toxic Epidermal Necrolysis are rare but life threatening severe cutaneous adverse reactions to drugs. To determine the epidemiology of SJS, TEN and SJS/TEN overlap in University Malaya Medical Centre (UMMC). Methods: All patients admitted to UMMC from year 2013-2015 for SJS, SJS/TEN, TEN were recruited. The classification of SJS, SJS/TEN overlap and TEN was made based on the criteria laid down by Bastuji et al.2 Results: A total of 32 patients were recorded to have SJS, SJS/TEN overlap and TEN from 2013 to 2015. Drugs (n=32, 86.49%) remained the most common aetiology of SJS and TEN. The top three commonest drugs are allopurinol (n=6), followed by carbamazepine (n=5) and bactrim (n=3). Conclusion: This study demonstrates that drugs were the most common cause of SJS/TEN. Antibiotics were the most common drug group that caused SJS/TEN. Awareness of the common etiology such as drug is important and high index of suspicion of SJS and TEN is needed if patients were on the above medications.
ABSTRACT
Necrose epidérmica tóxica ( NET ) e síndrome de Stevens - Johnson ( SSJ ) são considerados um espectro de reação mucocutânea aguda com risco de vida , que diferem apenas em termos de gravidade, muitas vezes induzidos por drogas. Vírus varicelazoster tem sido raramente relatada como agente etiológico em casos de NET. O nosso relato de caso destaca a associação do vírus varicela- zoster e TEN em um menino de 5 anos de idade.
Toxic epidermal necrolysis (TEN) and StevensJohnson syndrome (SJS) are considered a spectrum of acute life-threatening mucocutaneous reaction that differ only in severity, often induced by drugs. Varicella-zoster virus has been rarely reported as an etiological agent in TEN. Our case report highlights the association of varicella-zoster virus and TEN in a 5-year-old boy.
Subject(s)
Humans , Male , ChildABSTRACT
Introduction: Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN) , and drug reaction with eosinophilia and systemic symptoms (DRESS) are severe cutaneous adverse drug reactions (SCARs) related to a variety of medications. Objectives: We aim to document the epidemiological features, the causative drugs and clinical outcomes of patients with SCARs treated in Hospital Tengku Ampuan Rahimah (HTAR) between January 2009 and December 2013. Materials & Methods: A retrospective review of the data of all patients with SJS, TEN and DRESS treated from January 2009 to December 2013 was retrieved and analyzed. Results: A total of 33 SCARs patients were seen, which included SJS (25), TEN (3) and DRESS (5). The mean age was 42.8 years. The male-to-female ratio was 1.36:1. Allopurinol (33.3%) was the commonest offending drug, followed by antibiotics (30.3%), anticonvulsants (12.1%), non-steroidal anti-inflammatory drugs (12.1%) and traditional medications (6.1%). Eighty percent of SJS and all TEN and DRESS patients were given systemic corticosteroids. One patient with TEN (33.3%) was concurrently given intravenous immunoglobulin. All SJS patients survived. Two patients with TEN (66.7%) and one patient with DRESS (20%) succumbed due to sepsis. Conclusion: The commonest drugs implicated for SCARs in our study were allopurinol and antibiotics. Inappropriate use of these drugs leads to increased risk of SCARs. Early recognition and prompt treatment of patients with SCARs may improve their outcome.
ABSTRACT
Background Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare bullous mucocutaneous disease usually caused by drugs. We aim to determine the demographics, causes and outcomes of patients admitted with SJS, TEN and SJS-TEN overlap in Sarawak General Hospital. Materials and Methods A retrospective review of cases admitted to Sarawak General Hospital with SJS, TEN and SJS-TEN overlap from January 2004 to December 2007 was undertaken. Data regarding the demographic, causes and outcomes were collected from the case folders and subjected to descriptive statistical analysis using Microsoft Excel. Results Twenty four cases were admitted with 54.2% having SJS, 25% having SJS-TEN Overlap and 20.8% having TEN. With the mean ages of more than 40 years, patients with SJS and SJS-TEN overlap were older than patients with TEN, with a mean age of only 25.4 years. Seventy nine percent of cases were drugs induced. Anticonvulsants were the main culprit constituting 29.2% followed by allopurinol with 20.8%. Cases with SJS had the longest incubation period with mean of 21.6 days whereas cases with TEN had the longest mean hospital stay with 12.4 days. A 12.5% mortality rate was recorded with 2 deaths in the SJS-TEN overlap group and one death in the TEN group. All cases who were given intravenous immunoglobulin (IVIg) survived. Conclusion SSJS, SJS-TEN Overlap and TEN were mainly drug induced and have high mortality. IVIg treatment seems promising. Early recognition and optimal care in institution with dermatology service is essential in reducing morbidities and mortalities.