Abstract

ERYTHEMA MULTIFORME FOLLOWING CEFTRIAXONE ADMINISTRATION: A CASE OF DRUG-INDUCED DERMATOLOGIC REACTION

S. Iqra, S. Ayesha Ahamed, S. Farida, Dr. S. Prabhu Kiran Reddy*, Dr. C. Rajaram

ABSTRACT

Rationale: Erythema Multiforme (EM) is an acute, immune-mediated disorder, most commonly induced by Herpes simplex (HSV) infection or by using particular medications. It presents with cutaneous or mucosal lesions or both. Characteristic lesions are observed across the skin as distinctive target-like lesions with concentric color variation, occasionally accompanied by oral, vaginal, or ocular mucosal erosions or bullae. Patient Concerns: A 55-year-old female presented with shortness of breath, chest pain, and cough. After two days of treatment, the patient developed a maculopapular rash on her palms and feet. Following a comprehensive review of the patient's medical and medication history, it was suspected that the reaction was induced by the injection of ceftriaxone, which had been prescribed to treat hospital-acquired bacterial infection. Diagnosis: The patient was diagnosed with Erythema Multiforme (EM) triggered by ceftriaxone. Intervention: Treatment included discontinuation of all offending drugs and administration of various medications: Candid mouth paint, Kenocort oral paste for oral erosions, saline soaking for hemorrhagic crusting over lips, Povidone iodine mouth gargling, Emollient, T. BC/Ca/Vit C/Cap A&D, clotrimazole mouth paint, Chlorhexidine Gluconate, Metronidazole and Lignocaine Hydrochloride Gel, Triamcinolone Oromucosal Paste, Clotrimazole Cream IP 2% w/w, Fusidic Acid Cream IP 2% w/w, T. nifedipine 50mg, T. fluconazole 100mg. Outcomes: The patient responded favorably to treatment, with resolution of the rashes after five days of treatment. She was discharged from the hospital with instructions to continue T. fluconazole 100mg OD, T. multi vitamin OD, Dologel oral paste, Kenocort oral paste, and Candid mouth paint. Conclusion: This case underscores the importance of vigilant medication management and early intervention in suspected drug-induced cutaneous adverse reactions. Lesson: Patients using suspected drugs should be monitored closely. If they experience any suspected adverse reactions, these drugs should be discontinued immediately for improved outcomes. This situation emphasizes the importance of proactive education for both patients and healthcare providers regarding potential adverse drug reactions, particularly in high-risk populations, to prevent similar incidents from occurring in the future.

Keywords: Erythema Multiforme (EM), third-generation cephalosporins, adverse drug reactions, maculopapular rash, case study.