Cycloserine-induced Stevens-Johnson syndrome in an AIDS patient with multidrug-resistant tuberculosis.
We report a case of cycloserine-induced Stevens-Johnson syndrome (SJS) in a 38-year-old male with the acquired immune deficiency syndrome (AIDS) and multidrug resistant tuberculosis (MDR-TB). The patient developed a cutaneous reaction after 60 days of therapy with ofloxacin, streptomycin (SM), pyrazinamide (PZA), ethambutol (EMB), and cycloserine (CSN). All drugs were stopped and the rash improved. Due to the severity of his disease, anti-tuberculosis drugs were resumed, one at a time. The patient developed a recurrent rash consistent with SJS, which began when CSN was restarted. CSN was stopped and the SJS began to gradually resolve with palliative treatment despite continuation of the other anti-tuberculosis drugs. However, the patient's overall condition gradually deteriorated and he died. To our knowledge, this is the first case of probable CSN-related SJS.
Akula
S K
SK
Tulane University School of Medicine, New Orleans, Louisiana, USA.
Aruna
A S
AS
Johnson
J E
JE
Anderson
D S
DS
D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy*; D000328:Adult; D000904:Antibiotics, Antitubercular / Q000009:adverse effects* / Q000627:therapeutic use; D003523:Cycloserine / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005076:Exanthema / Q000139:chemically induced; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D013262:Stevens-Johnson Syndrome / Q000139:chemically induced* / Q000175:diagnosis; D018088:Tuberculosis, Multidrug-Resistant / Q000188:drug therapy*
D000904:Antibiotics, Antitubercular; D003523:Cycloserine