Case Report of Atypical Steven Johnson Syndrome in a Paediatric Patient

Abstract

INTRODUCTION:

Steven-Johnson Syndrome (SJS) is a rare mucocutaneous condition with variable severity. While pharmaceuticals are the most common triggers, aetiologies differ between paediatric and adult populations. This case report details an atypical presentation of SJS in a 10-year-old male in Cork, Ireland, and explores the differences in triggers across age groups.

METHODS:

Both the patient and the guardian provided consent to share this information for educational purposes.

RESULTS:

The patient exhibited an atypical, severe SJS presentation, including progressive lip oedema minimally responsive to prednisolone, alongside evolving black hemorrhagic bullae. Blood cultures identified Mycoplasma pneumoniae. Given a Naranjo Adverse Drug Reaction Probability Scale of 2, it was unlikely the commencement of antibiotics that triggered his condition given the known concurrent bacterial infection. Further investigations confirmed the absence of underlying immunological or chronic conditions.

DISCUSSION:

In adults, SJS is most frequently triggered by medications such as Non-steroidal anti-inflammatory agents (NSAIDS), anti-epileptics, and antibiotics. In contrast, paediatric SJS is more commonly caused by infectious agents, with Mycoplasma pneumoniae as the most frequent bacterial cause. Recognizing this distinction is vital for diagnosis, prevention, and management strategies.

CONCLUSION:

Although SJS is rare, it can have profound impacts on patients. Awareness of the differences in triggers between children and adults is crucial for effective prevention and management. Understanding these distinctions ensures healthcare providers and families are informed, ultimately improving patient outcomes.