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[PMID]: 29092853
[Au] Autor:Park JW; Curtis JR; Moon J; Song YW; Kim S; Lee EB
[Ad] Address:Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
[Ti] Title:Prophylactic effect of trimethoprim-sulfamethoxazole for pneumocystis pneumonia in patients with rheumatic diseases exposed to prolonged high-dose glucocorticoids.
[So] Source:Ann Rheum Dis;, 2017 Nov 01.
[Is] ISSN:1468-2060
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVES: To investigate the efficacy and safety of trimethoprim/sulfamethoxazole (TMP-SMX) as primary prophylaxis for pneumocystis pneumonia (PCP) in patients with rheumatic diseases receiving high-dose steroids. METHODS: The study included 1522 treatment episodes with prolonged (≥4 weeks) high-dose (≥30 mg/day prednisone) steroids in 1092 patients over a 12-year period. Of these, 262 treatment episodes involved TMP-SMX (prophylaxis group) while other episodes involved no prophylaxis (control group). Differences in 1-year PCP incidence and its mortality between the two groups were estimated using Cox regression. To minimise baseline imbalance, propensity score matching was performed and efficacy outcome was mainly assessed in the postmatched population (n=235 in both groups). RESULTS: During a total of 1474.4 person-years, 30 PCP cases occurred with a mortality rate of 36.7%. One non-fatal case occurred in the prophylaxis group. TMP-SMX significantly reduced the 1-year PCP incidence (adjusted HR=0.07(95% CI 0.01 to 0.53)) and related mortality (adjusted HR=0.08 (95% CI 0.0006 to 0.71)) in the postmatched population. The result of the same analysis performed in the whole population was consistent with that of the primary analysis. Incidence rate of adverse drug reactions (ADR) related to TMP-SMX was 21.2 (14.8-29.3)/100 person-years. Only two serious ADRs (including one Stevens-Johnson syndrome case) occurred. The number needed to treat for preventing one PCP (52 (33-124)) was lower than the number needed to harm for serious ADR (131 (55-∞)). CONCLUSION: TMP-SMX prophylaxis significantly reduces the PCP incidence with a favourable safety profile in patients with rheumatic disease receiving prolonged, high-dose steroids.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171102
[Lr] Last revision date:171102
[St] Status:Publisher

  2 / 5242 MEDLINE  
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[PMID]: 28940568
[Au] Autor:Morsy H; Taha EA; Nigm DA; Shahin R; Youssef EMK
[Ad] Address:Department of Dermatology, Venereology and Andrology , Assiut University, Egypt.
[Ti] Title:Serum IL-17 in patients with erythema multiforme or Stevens-Johnson syndrome/toxic epidermal necrolysis drug reaction, and correlation with disease severity.
[So] Source:Clin Exp Dermatol;42(8):868-873, 2017 Dec.
[Is] ISSN:1365-2230
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: There is strong evidence that drug-induced cutaneous eruptions have an immunological component. Interleukin (IL)-17, a proinflammatory cytokine that is predominantly produced by T helper 17 cells, has been linked to various autoimmune and inflammatory diseases. AIM: To measure serum IL-17 levels in patients with cutaneous drug reactions [erythema multiforme (EM) and Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN)] in order to study the associations between IL-17 and disease severity. METHODS: In total, 32 patients (13 with EM and 19 with SJS/TEN) and 15 age- and sex-matched healthy controls (HCs) were enrolled. Patients with SJS/TEN were assessed clinically using the SCORe of Toxic Epidermal Necrosis (SCORTEN) scale. Serum IL-17 levels were determined by ELISA. RESULTS: Serum IL-17 levels were significantly higher compared with HCs (16.46 ± 5.21 pg/mL) in the EM (35.1 ± 23.89 pg/mL, P < 0.02) and SJS/TEN (68.19 ± 35.42 pg/mL, P = 0.001) groups. IL-17 levels were also significantly higher in the SJS/TEN group than in the EM group (P = 0.004). Mean affected body surface area percentage was 0.9 ± 0.21 in the EM group and 22.8 ± 10.67 in the SJS/TEN group. The SJS/TEN SCORTEN ranged from 1 to 5, with a mean of 2.5 ± 1. Serum IL-17 level correlated positively with both percentage surface area of detached skin and SCORTEN. CONCLUSIONS: Serum IL-17 levels may have prognostic and diagnostic value in patients with EM or SJS/TEN reactions, and can provide a valuable approach in managment.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 171103
[Lr] Last revision date:171103
[St] Status:In-Process
[do] DOI:10.1111/ced.13213

  3 / 5242 MEDLINE  
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[PMID]: 28885988
[Au] Autor:Tempark T; Satapornpong P; Rerknimitr P; Nakkam N; Saksit N; Wattanakrai P; Jantararoungtong T; Koomdee N; Mahakkanukrauh A; Tassaneeyakul W; Suttisai S; Pratoomwun J; Klaewsongkram J; Rerkpattanapipat T; Sukasem C
[Ad] Address:Departments of aPediatrics, Division of Pediatric Dermatology bMedicine, Division of Dermatology, Skin and Allergy Research Unit cMedicine, Division of Allergy and Clinical Immunology, Skin and Allergy Research Unit, Faculty of Medicine, Chulalongkorn University dLaboratory for Pharmacogenomics, Somdech Phra Debaratana Medical Center (SDMC) eDepartment of Pathology, Division of Pharmacogenomics and Personalized Medicine fDepartment of Medicine, Division of Dermatology gDepartment of Medicine, Division of Allergy Immunology and Rheumatology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University hThe Thai Severe Cutaneous Adverse Drug Reaction (THAI-SCAR) Research Group, Bangkok Departments of iPharmacology jMedicine, Faculty of Medicine, Khon Kaen University, Khon Kaen kSchool of Pharmaceutical Sciences, University of Phayao, Phayao lPharmacy Department, Phrae Hospital, Phrae, Thailand.
[Ti] Title:Dapsone-induced severe cutaneous adverse drug reactions are strongly linked with HLA-B*13: 01 allele in the Thai population.
[So] Source:Pharmacogenet Genomics;27(12):429-437, 2017 Dec.
[Is] ISSN:1744-6880
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:OBJECTIVES: A previous publication in Chinese leprosy patients showed that the HLA-B*13:01 allele is a strong genetic marker for dapsone-induced drug hypersensitivity reactions, however there are no data describing whether HLA-B*13:01 is a valid marker for prediction of dapsone-induced drug hypersensitivity reactions in other ethnicities or nonleprosy patients. The aim of this study is to investigate whether there is an association between HLA genotypes and dapsone-induced severe cutaneous adverse reactions (SCARs) in Thai nonleprosy patients. PATIENTS AND METHODS: HLA-B genotypes of 15 patients with dapsone-induced SCARs (11 drug reaction with eosinophilia and systemic symptoms, 4 Stevens-Johnson syndrome/toxic epidermal necrolysis), 29 control patients, and 986 subjects from the general Thai population were determined by the reverse PCR sequence-specific oligonucleotides probe. RESULTS: The HLA-B*13:01 allele was significantly associated with dapsone-induced SCARs compared with dapsone-tolerant controls (odds ratio: 54.00, 95% confidence interval: 7.96-366.16, P=0.0001) and the general population (odds ratio: 26.11, 95% confidence interval: 7.27-93.75, P=0.0001). In addition, HLA-B*13:01 associated with dapsone-induced SJS-TEN (OR: 40.50, 95% confidence interval: 2.78-591.01, P=0.0070) and DRESS (OR: 60.75, 95% confidence interval: 7.44-496.18, P=0.0001). CONCLUSION: This study demonstrated an association between HLA-B*13:01 and dapsone-induced SCARs including Stevens-Johnson syndrome/toxic epidermal necrolysis and drug reaction with eosinophilia and systemic symptoms in nonleprosy patients. Moreover, these results suggest that the HLA-B*13:01 allele may be a useful genetic marker for prediction of dapsone-induced SCARs in Thai and Han-Chinese populations.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 171102
[Lr] Last revision date:171102
[St] Status:In-Process
[do] DOI:10.1097/FPC.0000000000000306

  4 / 5242 MEDLINE  
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[PMID]: 28724844
[Au] Autor:Kinoshita Y; Saeki H
[Ad] Address:Department of Dermatology, Nippon Medical School.
[Ti] Title:A Review of the Active Treatments for Toxic Epidermal Necrolysis.
[So] Source:J Nippon Med Sch;84(3):110-117, 2017.
[Is] ISSN:1347-3409
[Cp] Country of publication:Japan
[La] Language:eng
[Ab] Abstract:Toxic epidermal necrolysis (TEN) is a severe adverse drug reaction associated with the separation of skin and mucous membranes at the dermal-epidermal junction. Although it is rare, many treatments have been trialed because of its high mortality rate. Active interventions performed to date include the use of systemic corticosteroids, intravenous immunoglobulins (IVIg), cyclosporine, plasmapheresis, anti-tumor necrosis factor drugs and N-acetylcysteine, but none has been established as the most effective therapy. IVIg and short-term high-dose corticosteroids were regarded as the most promising treatments for TEN in a comprehensive review of all reported TEN cases from 1975-2003. When used with an appropriate dose and timing, the beneficial effects of IVIg can be maximized. Although no randomized controlled trials have been conducted, cyclosporine and plasmapheresis are considered to be beneficial. As no gold standard for active intervention for TEN has been established, the choice of treatment relies partly on the available guidelines and the experience of the dermatologist. There is still much to be investigated regarding the pathogenesis of TEN, and new findings may contribute to the identification of an effective active intervention strategy.
[Mh] MeSH terms primary: Glucocorticoids/administration & dosage
Immunoglobulins, Intravenous/administration & dosage
Stevens-Johnson Syndrome/therapy
[Mh] MeSH terms secundary: Acetylcysteine/administration & dosage
Cyclosporine/administration & dosage
Etanercept/administration & dosage
Humans
Immunosuppressive Agents/administration & dosage
Infliximab/administration & dosage
Plasmapheresis
Thalidomide/administration & dosage
Tumor Necrosis Factor-alpha/antagonists & inhibitors
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Nm] Name of substance:0 (Glucocorticoids); 0 (Immunoglobulins, Intravenous); 0 (Immunosuppressive Agents); 0 (Tumor Necrosis Factor-alpha); 4Z8R6ORS6L (Thalidomide); 83HN0GTJ6D (Cyclosporine); B72HH48FLU (Infliximab); OP401G7OJC (Etanercept); WYQ7N0BPYC (Acetylcysteine)
[Em] Entry month:1710
[Cu] Class update date: 171031
[Lr] Last revision date:171031
[Js] Journal subset:IM
[Da] Date of entry for processing:170720
[St] Status:MEDLINE
[do] DOI:10.1272/jnms.84.110

  5 / 5242 MEDLINE  
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[PMID]: 28267083
[Au] Autor:Faraci M; Giardino S; Lanino E; Morreale G; Ghibaudo E; Francesia Berta M; Risso M; Castagnola E; Ripaldi M; Moscatelli A; Ghigliotti G
[Ad] Address:*Paediatric Haematology-Oncology Department, Stem Cell Transplantation Unit †Immuno-Haematology and Transfusion Medicine Service ‡Infectious Diseases Unit ∥Intensive Care Unit, Istituto G. Gaslini ¶Dermatology Clinic, S Martino IST Hospital, Genova §SCT Unit Santobono-Pausilipon Hospital, Napoli, Italy.
[Ti] Title:Toxic Epidermal Necrolysis-like Reaction After Hematopoietic Stem Cell Transplantation in Children.
[So] Source:J Pediatr Hematol Oncol;39(4):254-258, 2017 May.
[Is] ISSN:1536-3678
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:This study report clinical course, etiology, management, and long-term outcome of children who developed toxic epidermal necrolysis-like reaction (TEN-LR) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). We retrospectively collected children with TEN-LR occurring after allo-HSCT performed in 2 pediatric bone marrow units between 2005 and 2014. We identified 6 cases of TEN-LR of 322 patients (1.8%). Possible triggers of TEN included antibiotics, antiepileptics, antimycotics, and Mycoplasma infection. In 3 patients TEN-LR occurred concurrently with severe multiorgan acute graft versus host disease. The management of TEN included administration of high doses of intravenous immunoglobulins and steroids (n=6), anti-tumor necrosis factor (n=3), and plasmapheresis (n=3) and whenever possible, discontinuation of the potentially causative drugs. Four patients (66%) reached a complete clinical response of TEN-LR after a median of 11.2 days. Two children (34%) are presently alive, 1 with long-term ocular sequelae. TEN-LR is a potentially lethal complication that may occur after HSCT also in pediatric patients. In our experience, TEN-LR and acute graft versus host disease probably coexisted and an overlap between the 2 forms is suggested. The multidisciplinary approaches involving specialized nurses, hematologists, dermatologists, burn surgeons, and infectious disease specialists is crucial to treat these patients.
[Mh] MeSH terms primary: Hematopoietic Stem Cell Transplantation/adverse effects
Stevens-Johnson Syndrome/etiology
Stevens-Johnson Syndrome/therapy
[Mh] MeSH terms secundary: Adolescent
Antibodies, Monoclonal/therapeutic use
Child
Child, Preschool
Female
Humans
Immunoglobulins, Intravenous/administration & dosage
Male
Plasmapheresis
Retrospective Studies
Tumor Necrosis Factor-alpha/immunology
[Pt] Publication type:JOURNAL ARTICLE; MULTICENTER STUDY
[Nm] Name of substance:0 (Antibodies, Monoclonal); 0 (Immunoglobulins, Intravenous); 0 (Tumor Necrosis Factor-alpha)
[Em] Entry month:1710
[Cu] Class update date: 171031
[Lr] Last revision date:171031
[Js] Journal subset:IM
[Da] Date of entry for processing:170307
[St] Status:MEDLINE
[do] DOI:10.1097/MPH.0000000000000820

  6 / 5242 MEDLINE  
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[PMID]: 28314701
[Au] Autor:Van Batavia JP; Chu DI; Long CJ; Jen M; Canning DA; Weiss DA
[Ad] Address:Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA. Electronic address: vanbatavij@email.chop.edu.
[Ti] Title:Genitourinary involvement and management in children with Stevens-Johnson syndrome and toxic epidermal necrolysis.
[So] Source:J Pediatr Urol;13(5):490.e1-490.e7, 2017 Oct.
[Is] ISSN:1873-4898
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are devastating hypersensitivity disorders that cause epidermal cell death and can affect all epidermal surfaces, including the urethra, vagina, labial and scrotal skin. Despite the well-described ocular and orofacial manifestations of SJS/TEN, there is a paucity of reports on the genitourinary (GU) symptoms and their management. Specifically, consulting services often ask the pediatric urology team if it is safe to place a urethral catheter, but there is no data in the literature to help guide management. The present study sought to review all pediatric cases of SJS/TEN in a tertiary care hospital to determine the incidence and optimal management of GU manifestations, including the use of urethral catheters. METHODS: With IRB approval, cases of SJS and TEN that were managed as an inpatient between January 2008 and June 2015 were retrospectively reviewed in order to identify the extent of GU involvement/manifestations, the treatment provided, use of urethral catheterization and long-term follow-up or complications. RESULTS: Thirty-one patients (15 female, 16 male; age range 2-18 years) presented with SJS or TEN over the study period. Etiologies for SJS/TEN included mycoplasma infection (48%) and medications (45%). Incidences of GU manifestations at presentation and their management are shown in Summary Table. Overall, 74% of patients had genital involvement of skin lesions. In 12 cases (39%), urology consultation was obtained. Twenty patients (61%) complained of dysuria and one child had gross hematuria in the setting of meatal lesion. Petroleum jelly was used in the majority of patients. A urethral catheter was placed in eight patients (25.8%, four female, four male) with a range of duration of 7-23 days. No patient developed hematuria or any other complications (i.e. strictures or urinary symptoms) after catheter removal. One boy required lysis of penile adhesions in the short-term. One of each gender developed penile and labial adhesions on long-term follow-up that self-resolved. CONCLUSIONS: GU involvement in SJS/TEN occurred in almost three-quarters of patients and was managed conservatively like other skin/mucosal manifestations. Long-term sequelae were rare and urethral catheterization appeared to be safe, without any short-term or long-term complications.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1703
[Cu] Class update date: 171029
[Lr] Last revision date:171029
[St] Status:In-Process

  7 / 5242 MEDLINE  
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[PMID]: 29080314
[Au] Autor:Miyazawa H; Nishie W; Hata H; Matsumura K; Shimizu H
[Ad] Address:Department of Dermatology Faculty of Medicine and Graduate School of Medicine, Hokkaido University, N15 W7, Kita-ku, Sapporo, 060-8638, Japan.
[Ti] Title:A severe case of mango dermatitis.
[So] Source:J Eur Acad Dermatol Venereol;, 2017 Oct 28.
[Is] ISSN:1468-3083
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:A 27-year-old Japanese woman visited our hospital with eruptions on the lips, which had appeared two days after she took acetaminophen. At day 15, her lips were severely swollen with erosions, most of which were covered with dense crusts (Figure 1). Clinically, Stevens-Johnson syndrome due to acetaminophen was suspected. However, the drug-induced lymphocyte stimulation test for the reagent was negative (stimulation index: 156%; normal: < 179%), and the eruption did not recur after she resumed acetaminophen. This article is protected by copyright. All rights reserved.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171028
[Lr] Last revision date:171028
[St] Status:Publisher
[do] DOI:10.1111/jdv.14656

  8 / 5242 MEDLINE  
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[PMID]: 29076187
[Au] Autor:Devi K
[Ad] Address:Department of Dermatology, Government Medical College, Thrissur, Kerala, India.
[Ti] Title:The association of HLA B*15:02 allele and Stevens-Johnson syndrome/toxic epidermal necrolysis induced by aromatic anticonvulsant drugs in a South Indian population.
[So] Source:Int J Dermatol;, 2017 Oct 26.
[Is] ISSN:1365-4632
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:BACKGROUND: The presence of HLA-B*15:02 allele is considered a risk factor for development of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) in patients taking aromatic anticonvulsant drugs like carbamazepine and phenytoin. The genetic association is ethnicity specific. Testing for HLA-B*15:02 allele is suggested as a prerequisite before starting carbamazepine in certain ethnic groups. There are only a few/no studies from south India on HLA association of SJS/TEN. AIMS: To identify any association between HLA-B*15:02 allele and SJS/TEN induced by carbamazepine/phenytoin among native population. METHODS (INCLUDING SETTINGS, DESIGN, AND STATISTICAL ANALYSIS USED): A case-control study done in a tertiary care center at Kottayam in Kerala state of south India. Cases were 12 native patients who developed SJS/TEN owing to aromatic anticonvulsant drugs (phenytoin - 8; carbamazepine - 4), and controls were 11 persons tolerant to these drugs from unrelated families of the same ethnic group. HLA-B typing was done by PCR SSP method. RESULTS: There was only one HLA-B*15:02 carrier among cases and controls. He/she had SJS/TEN induced by carbamazepine. CONCLUSIONS: Association of HLA-B*15:02 with phenytoin-induced SJS/TEN is rare in the population studied. The one limitation of the study was the small sample size.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171027
[Lr] Last revision date:171027
[St] Status:Publisher
[do] DOI:10.1111/ijd.13812

  9 / 5242 MEDLINE  
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[PMID]: 28411832
[Au] Autor:Stern RS; Divito SJ
[Ad] Address:Beth Israel Deaconess Medical, Boston, Massachusetts, USA. Electronic address: rstern@bidmc.harvard.edu.
[Ti] Title:Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: Associations, Outcomes, and Pathobiology-Thirty Years of Progress but Still Much to Be Done.
[So] Source:J Invest Dermatol;137(5):1004-1008, 2017 May.
[Is] ISSN:1523-1747
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Although rare, Stevens-Johnson syndrome and toxic epidermal necrolysis remain among the most devastating of acute conditions involving the skin. In the past 30 years, tremendous progress has been made in understanding the causes and pathobiology of this often life-threatening condition. Su et al demonstrate associations between IL 15 serum levels and the outcome of patients with Stevens-Johnson syndrome and toxic epidermal necrolysis. Their findings provide ideas for further investigations that may help us better understand the role of cytokines in this T-cell mediate disease and provides clues to possible new therapies.
[Mh] MeSH terms primary: Acute Disease
Stevens-Johnson Syndrome
[Mh] MeSH terms secundary: Cytokines
Humans
Interleukin-15
Skin
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:0 (Cytokines); 0 (Interleukin-15)
[Em] Entry month:1710
[Cu] Class update date: 171026
[Lr] Last revision date:171026
[Js] Journal subset:IM
[Da] Date of entry for processing:170416
[St] Status:MEDLINE

  10 / 5242 MEDLINE  
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[PMID]: 29065395
[Au] Autor:Tajmir-Riahi A; Wörl P; Harrer T; Schliep S; Schuler G; Simon M
[Ad] Address:Departmens of Dermatology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany.
[Ti] Title:Life-Threatening Atypical Case of Acute Generalized Exanthematous Pustulosis.
[So] Source:Int Arch Allergy Immunol;174(2):108-111, 2017 Oct 25.
[Is] ISSN:1423-0097
[Cp] Country of publication:Switzerland
[La] Language:eng
[Ab] Abstract:Antibiotics are known to cause severe cutaneous adverse reactions, such as the rare acute generalized exanthematous pustulosis (AGEP). Unlike Stevens-Johnson syndrome or toxic epidermal necrolysis, AGEP is rarely life-threatening. Systemic involvement is not typical, and if present usually coincides with a mild elevation of the hepatic enzymes and a decrease in renal function. Hence, AGEP is known to have a good prognosis and to be life-threatening only in elderly patients or patients with chronic diseases. Herein, we report a case of AGEP in a young healthy male leading to systemic inflammatory response syndrome and to treatment in an intensive care unit after being treated with 5 different antibiotics. Initial symptoms were not indicative for AGEP and the patient's course of disease led promptly to critical cardiorespiratory symptoms and systemic inflammatory response syndrome. We assume that the administration of the 5 different antibiotics resulted in type IV allergy as well as secondary infection with Enterococcus faecium and Staphylococcus aureus, while the underlying periodontitis also contributed to the severity of this case.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171024
[Lr] Last revision date:171024
[St] Status:Publisher
[do] DOI:10.1159/000480700


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