Abstract

FLESH ON FIRE: THE DEVASTATING CONSEQUENCES OF TOXIC EPIDERMAL NECROLYSIS

Dr. Anulekha N.*, Dr. Anuradha H. V.

ABSTRACT

Background: Toxic Epidermal Necrolysis (TEN) is a rare but potentially fatal adverse drug reaction characterized by widespread epidermal necrosis and detachment involving more than 30% of the body surface area. This is a rare case of cefpodoxime-induced TEN in a pediatric patient and emphasize the importance of early diagnosis and supportive care. Case Summary: An eight-year-old female presented with multiple vesiculobullous lesions involving the trunk, limbs, and mucosa following three days of cefpodoxime therapy for fever. The drug was discontinued immediately, and the child was managed in the intensive care unit with intravenous fluids, systemic corticosteroids, and intravenous immunoglobulin. Based on WHO-UMC criteria, the adverse drug reaction was categorized as probable. Gradual re-epithelialization of lesions occurredover two weeks, with complete recovery after 21 days. Conclusion: TEN is a dermatological emergency that requires prompt drug withdrawal and multidisciplinary supportive care. This case highlights the potential of even commonly prescribed antibiotics like cefpodoxime to cause severe adverse drug reactions.

Keywords: Toxic Epidermal Necrolysis, Cefpodoxime, Adverse Drug Reaction, Cephalosporins, Stevens–Johnson Syndrome.