Toxic Epidermal Necrolysis with Sepsis: Early Recognition and Intervention in a Critical Case
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Toxic epidermal necrolysis (TEN) is a rare but severe skin condition, often triggered by adverse drug reactions, with a high mortality rate of 30%. This case report describes the management of a 66-year-old male patient with TEN and sepsis. The patient presented with flaccid bullae, erosions, and epidermal detachment covering more than 30% of the body surface area, accompanied by a positive Nikolsky sign. Three days prior, he had taken Carbamazepine, Paracetamol, and Gabapentin. On examination, he had a high temperature, labored breathing, a Glasgow Coma Scale score of 14, a mean arterial pressure of 80 mmHg, platelet count of 70 × 10³/µl, and creatinine level of 1.49 mg/dl. The patient was diagnosed with TEN complicated by sepsis. Treatment included stopping the suspected medications, administering meropenem for sepsis, fluid resuscitation, blood transfusion, electrolyte replacement, and wound care. After two days of treatment, the patient regained full consciousness, vital signs stabilized, and laboratory results normalized. TEN is a life-threatening condition requiring urgent supportive care to prevent complications such as sepsis. This case highlights the importance of immediate intervention, careful selection of antibiotics, and multidisciplinary management. Timely treatment and cautious medication choices are crucial for improving outcomes in patients with TEN and sepsis.
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