Stevens-Johnson syndrome induced by Ampicillin. A case report

Abstract

Background: Stevens-Johnson Syndrome is defined as a rare mucocutaneous hypersensitivity reaction, whose etiology is associated with an adverse reaction to medications, herpes or Mycoplasma infections and others. The aim is to present a clinical case of Stevens-Johnson Syndrome with oral manifestations. 

Clinical Presentation: Male patient, 50 years old, referred to the Stomatology Unit of Hospital Señor del Milagro, Salta, Argentina, with multiple bleeding and crusty lesions in the oral cavity, evident odynophagia and lymphadenopathy. Medicated with ampicillin for a nonspecific infection. General physical examination revealed hemorrhagic lesions on the face, trunk and extremities of 15 days of evolution. It was diagnosed as Stevens Johnson Syndrome induced by ampicillin, treated with dexamethasone in high doses, with remission after one week of treatment. 

Clinical relevance: Carrying out a differential diagnosis of vesicular-bullous lesions to provide timely treatment is essential. The literature is extensive regarding the lack of clarity about the pathophysiology of SJS and its interaction with drugs. The etiological link between ampicillin and SJS is poorly reported, this being one of the few documented cases of this relationship. 

Conclusion: General dentist should recognize the initial signs and symptoms associated with SJS, allowing early diagnosis and timely elimination of the suspected drug, significantly improving the prognosis and course of the disease