“Toxic Epidermal Necrolysis (TEN)” - A Probable Adverse Reaction of Erythromycin, Quinine and/or Ondansetron- Case Report

Toxic epidermal Necrolysis (TEN) Barvaliya et al.

Abstract

Toxic epidermal necrolysis (TEN) is characterized by confluence of blisters with positive Nikolsky sign and involvement of more than 30% of body surface area. We reported a case of a 17 year old male who developed TEN after commencing erythromycin 500 mg, quinine 300 mg and ondansetron 8 mg for sore throat, fever and vomiting. Diagnosis of TEN was confirmed by biopsy. Laboratory results showed leucopenia, thrombocytopenia and elevated liver enzymes. Offending drugs were stopped after the admission and supportive treatment and ventilator support provided, but patient died because of severity of reaction. Total cost of management was Rs.16,358/-. This case highlights that TEN is a life-threatening condition associated with a high incidence of mortality and economic burden to a patient.