Abstract:
Background. Stevens-Johnson Syndrome (SJS) is a rare but severe immune-mediated
adverse drug reaction. It falls under the category of delayed hypersensitivity reactions and
is characterized by the detachment of the epidermis and mucous membranes. Medications
are the most common cause of Stevens-Johnson Syndrome.
Objective(s). We aimed to present a detailed clinical case of Stevens-Johnson syndrome that
occurred in a 40-year-old patient, following the administration of an antibiotic from the
fluoroquinolone class.
Materials and methods. A 40-year-old patient undergoing treatment with levofloxacin
prescribed for otitis, admitted to the General Therapy and Allergology Department of the
Timofei Moșneaga Republican Clinical Hospital on day 3 of treatment, with extensive
cutaneo-mucous lesions characteristic of a severe cutaneous adverse reaction (SCAR).
Results. A 40-year-old patient, with no history of allergies, presents with generalized
maculopapular rash, bullae, mucosal erosions, on day 3 of levofloxacin treatment for otitis.
The cutaneous and mucosal manifestations were consistent with a severe drug-induced
cutaneous adverse reaction. Laboratory investigations revealed an inflammatory syndrome
with increased C-reactive protein and circulating immune complexes, both elevated
threefold. Treatment included replacing levofloxacin with alternatives from other classes of
antibiotics, systemic (prednisolone 0.5–1.0 mg/kg) and topical corticosteroids, with positive
evolution.
Conclusion(s). SJS is a rare but severe condition that is frequently caused by medications.
In rare cases, fluoroquinolones can cause delayed hypersensitivity reactions. It must be
treated immediately in the hospital. Early recognition of symptoms and correct treatment
are essential.
