zithromax and Stevens-Johnson-Syndrome

Macrolides are one of the most commonly prescribed antibiotics. In several studies, their use was associated with the occurrence of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). This review aimed to explore and summarize available cases of SJS/TEN suspected to be associated with the use of macrolide antibiotics reported in the literature. Electronic searches were conducted in PubMed/MEDLINE, Web of Science, Scopus, and Serbian Citation Index (SCIndeks). Twenty-five publications describing a total of 27 patients were included. Cases of SJS/TEN which satisfied inclusion criteria were found for azithromycin (n = 11), clarithromycin (n = 7), erythromycin (n = 5), roxithromycin (n = 2), and telithromycin (n = 2). The age of the patients ranged from 2 to 77 years (median: 29 years). There were 14 female (51.9%) and 13 male (48.1%) patients. SJS was diagnosed in 16 patients (59.3%), TEN in 10 patients (37.0%), and SJS/TEN overlap in one patient (3.7%). Time to onset of the first symptoms ranged from 1 to 14 days (median: 3 days). All patients received some form of supportive and symptomatic care. Systemic corticosteroids were reported to be administered in 12 patients (44.4%) and intravenous immunoglobulin in five patients (18.5%). Three patients (11.1%) died. Considering that SJS/TEN is a severe and potentially life-threatening reaction, physicians should be aware that they could be adverse effects of macrolide antibiotics and keep in mind that prompt recognition of SJS/TEN and discontinuation of the culprit drug in combination with supportive care is essential.

Topics: Anti-Bacterial Agents; Azithromycin; Clarithromycin; Erythromycin; Humans; Ketolides; Macrolides; Roxithromycin; Stevens-Johnson Syndrome

Stevens-Johnson syndrome (SJS) is an acute blistering disease of the skin and mucous membranes. SJS in children is not common but potentially serious disease. But the epidemiology of SJS in China is not well defined.. A 6-year-old boy was initially diagnosed as pneumonia admitted to hospital after admission, and the body appears red rash with blisters, skin damage, lip debaucjed, repeated high fever, and rapid progression.. SJS often results from an allergy reaction response to a range of drugs. It is a clinical diagnosis suggested by fever and malaise followed by an extensive painful, nonblanching, macular rash that commonly progresses to blistering or sloughing, and mucositis.. The boy was treated with continuous renal replacement therapy, anti-infection therapy, high-dose glucocorticoid treatment, and symptomatic treatment.. The patient was recovered after 33 days of treatment.. The current treatment is mainly symptomatic treatment, and for the patient, it is important to make skin care related well, included early out blisters at effusion, reducing skin ulceration of the mucosa area, keeping skin clean, removing mucosa secretion and blood clots, doing eye care related, preventing the complications, ensuring adequate intake of nutrition and warm and so on.

Topics: Anti-Bacterial Agents; Azithromycin; Child; Humans; Male; Pneumonia; Skin Care; Stevens-Johnson Syndrome

Topics: Adolescent; Azithromycin; Child; Conjunctivitis; Fluid Therapy; Humans; Lidocaine; Male; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Stevens-Johnson Syndrome; Stomatitis; Urethritis

Topics: Adult; Agglutination Tests; Anti-Bacterial Agents; Azithromycin; Diagnosis, Differential; Female; Humans; Infusions, Intravenous; Mucositis; Mycoplasma pneumoniae; Pneumonia, Mycoplasma; Stevens-Johnson Syndrome; Stomatitis; Treatment Outcome

Topics: Azithromycin; Child; Female; Humans; Methylprednisolone; Mucositis; Mycoplasma; Pneumonia, Mycoplasma; Skin Diseases; Stevens-Johnson Syndrome; Treatment Outcome

Topics: Administration, Oral; Anti-Bacterial Agents; Azithromycin; Child, Preschool; Conjunctivitis; Cough; Diagnosis, Differential; Fever; Humans; Male; Mucocutaneous Lymph Node Syndrome; Mucositis; Mycoplasma pneumoniae; Stevens-Johnson Syndrome

Azithromycin is a commonly prescribed antibiotic but is not considered a common etiologic agent for Stevens-Johnson syndrome (SJS). SJS is a dermatologic emergency that occurs within a spectrum of severity and can result in severe morbidity and mortality.

Topics: Anti-Bacterial Agents; Azithromycin; Diagnosis, Differential; Emergencies; Humans; Male; Middle Aged; Stevens-Johnson Syndrome

Topics: Anti-Bacterial Agents; Azithromycin; Humans; Inappropriate Prescribing; Male; Middle Aged; Stevens-Johnson Syndrome

We herein describe a case of secondary syphilis in a patient with HIV infection that presented with an unusually diffuse polyostotic osteitis with skull involvement. Syphilis has to be added to the differential diagnosis of extensive inflammatory bone pain in patients at risk, especially if pain worsens at night.

Topics: Adult; AIDS-Related Opportunistic Infections; Anti-Bacterial Agents; Azithromycin; beta-Lactams; Doxycycline; Humans; Male; Osteitis; Radiography; Skull; Stevens-Johnson Syndrome; Syphilis; Treatment Outcome

Vanishing bile duct syndrome is a severe cholestatic disease associated with toxic effects of medications. Stevens-Johnson syndrome is a hypersensitivity disorder that may also be caused by medications. We present a case of a 62-year-old male patient who developed vanishing bile duct syndrome a month after Stevens-Johnson syndrome. These adverse drug reactions were associated with the use of azithromycin (500 mg daily for 3 days). The patient was initially treated for Stevens-Johnson syndrome with steroids, antihistamines and proton pump inhibitors and fully recovered. However, a month after the beginning of Stevens-Johnson syndrome, he developed vanishing bile duct syndrome and was treated with steroids, ursodeoxycholic acid, antihistamines and tacrolimus. Unfortunately, the treatment was unsuccessful and he was listed for liver transplantation which was performed 7 months after the beginning of jaundice. This is the first case of vanishing bile duct syndrome associated with the use of azithromycin and one of few that reports vanishing bile duct syndrome and Stevens-Johnson syndrome co-occurrence.

Topics: Anti-Bacterial Agents; Azithromycin; Bile Duct Diseases; Cholestasis; Humans; Male; Middle Aged; Stevens-Johnson Syndrome

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Azithromycin; Humans; Male; Mycoplasma Infections; Mycoplasma pneumoniae; Stevens-Johnson Syndrome

Linear immunoglobulin A (IgA) bullous dermatosis (LABD) is a rare autoimmune disorder characterized by vesiculobullous mucocutaneous eruptions. LABD also has been reported as a drug-induced reaction. Idiopathic LABD and drug-induced LABD are clinically indistinguishable and can resemble bullous pemphigoid, dermatitis herpetiformis, or bullous erythema multiforme. LABD is diagnosed with direct immunofluorescence (DIF), and idiopathic LABD can be distinguished from drug-induced LABD with a careful medication history. We present the case of a 54-year-old man with drug-induced LABD after ingestion of rimantadine, zanamivir, and azithromycin for presumed influenza. The patient's bullous eruption resolved with discontinuation of the offending medications and treatment with prednisone and pentoxifylline.

Topics: Anti-Infective Agents; Autoimmune Diseases; Azithromycin; Diagnosis, Differential; Drug Eruptions; Fluorescent Antibody Technique, Direct; Humans; Immunoglobulin A; Male; Middle Aged; Rimantadine; Skin; Skin Diseases, Vesiculobullous; Stevens-Johnson Syndrome; Zanamivir

Stevens-Johnson syndrome mostly involves the skin and mucous membranes. The diagnosis is made when the characteristic rash appears 1 to 3 weeks after exposure to a known stimulus and cannot be explained by some other diagnosis. A 62-year-old woman was admitted for evaluation of toxo-allergic dermatitis and collagenosis. Ten days prior to admission she was taking a course of azithromycin for upper respiratory tract infection. After a few days she was feeling better but maculopapular, erythematous rash developed over her palms, accompanied by fever and chills as well as reddish discoloration around her eyes. Within the next few days the rash progressed to the feet. Routine hematologic, biochemical and immunologic studies did not confirm the diagnosis of inflammatory rheumatic disease. Corticosteroid therapy with methylprednisolone (1 mg/kg) for the presumed Stevens-Johnson syndrome was started and her condition improved in several days; she became afebrile and her skin lesions gradually disappeared. There is only one report, in a child, documenting the association of Stevens-Johnson syndrome with azithromycin, as in this patient.

Topics: Anti-Bacterial Agents; Azithromycin; Female; Humans; Middle Aged; Respiratory Tract Infections; Stevens-Johnson Syndrome

Topics: Azithromycin; Child, Preschool; Fever; Follow-Up Studies; Herpes Simplex; Humans; Male; Rare Diseases; Recurrence; Risk Assessment; Severity of Illness Index; Stevens-Johnson Syndrome

To describe the clinical and laboratory features of infectious crystalline keratopathy and endophthalmitis secondary to Mycobacterium abscessus in a patient with Stevens-Johnson syndrome.. Case report. A 19-year-old man with a history of Stevens-Johnson syndrome and multiple corneal transplants developed white crystalline corneal infiltrates.. Anterior chamber aspirate disclosed acid-fast bacilli. A repeat corneal transplant was performed and antibiotic therapy begun. Histopathology showed focal acute inflammation surrounding collections of acid-fast bacilli, which were speciated as M. abscessus.. M. abscessus is a cause of infectious crystalline keratopathy and endophthalmitis. Risk factors include ocular surface disease, corneal transplantation, and immunosuppressive therapy.

Topics: Adult; Amikacin; Anterior Chamber; Azithromycin; Corneal Diseases; Drug Therapy, Combination; Endophthalmitis; Eye Infections, Bacterial; Humans; Keratoplasty, Penetrating; Male; Mycobacterium; Mycobacterium Infections; Stevens-Johnson Syndrome; Vision, Monocular