Stevens-Johnson Syndrome
Considerations
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Severe life threatening drug reaction with high morbidity/mortality
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Possible difficult airway (edema & ulcerations)
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Respiratory:
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Hypoxia
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Hypersecretions
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Pulmonary edema & ARDS
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Blebs & pneumothorax
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Tracheobronchitis
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Cardiovascular:
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Septic shock common cause of death
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Hypovolemia, third spacing
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Renal: electrolyte abnormalities, renal failure
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Significant pain requiring multimodal analgesia
Treatment
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Transfer to ICU/burn unit
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Institute supportive care:
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Fluid & electrolyte management (fluids: use parkland formula in acute phase)
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Analgesia
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Nutritional support
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Temperature management
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Antibiotics for superinfections
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Adjunctive therapies (all controversial, no good evidence):
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Steroids if indicated
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IVIG
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Cyclosporine
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Plasmapheresis
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Anti-TNF monoclonal antibodies
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