Erythema multiforme under the treatment with amoxicillin/clavulanate: a case report and review of the literature

To report a case of Erythema Multiforme [EM] in a boy who was treated with oral Amoxicillin/Clavulanate for upper respiratory infection. A 14-years-old boy with upper respiratory infection was treated with amoxicillin/calvulanate 625 milligram every eight hours for a week for his symptoms. Four days later, he developed erythematous rash all over the body plus genital lesion, and mouth ulceration. The skin biopsies confirmed Erythema Multiforme [EM]. The drug was immediately stopped and he was given a corticosteroid orally and supportive therapy for his symptoms. Within a few days, his skin and mouth lesions were dramatically improved and he was discharged on prednisone tapering dose for additional ten days. Erythema multiforme [EM] is an acute mucocutaneous hypersensitivity reaction that occurs in response to certain types of drugs, chemicals or infections. The severity of the skin lesions is variable. A Medline search from 1984 to October 2007 revealed only five cases of amoxicillin/clavulanate induced EM. The Naranjo algorithm score was 4 for EM in our patient, representing a possible relationship of amoxicillin/clavulanate treatment. We described the case of a 14-year-old boy who developed EM while on amoxicillin/clavulanate. The patient completely recovered after stopping the offending drug and treated with oral prednisone and supportive therapy