[Mild form of Lyell's syndrome as an consequence of inappropriate BCG revaccination--case report].
In this case report a rare adverse event (mild toxic epidermic necrolysis (Lyell)) was described. Incorrect a purified protein derivative (PPD) administration involves false negative tuberculin test (TT): BCG vaccine was injected even though high immunization to BCG. Mild, benign epidermic necrolysis, fever, mononucleosis-like syndrome, splenomegaly and lymphadenopathy were observed. Evaluation of white blood cells was done by automatic (simultaneously two analysers: Baker 900 plus and Technicon, Bayer) and by microscopic methods and revealed high lymphocyte activation (blastic transformation), lymphocytosis and high eosinophilia.. Wiener and coworkers describe interleukin-2-induced dermatotoxicity resembling toxic epidermal necrolysis. Further the most common side effects of IL-2 are skin eruptions and eosinophilia. Careful analysis yielded the conclusions that Lyell's syndrome may be fatal consequence of inappropriate revaccination, hyperergia--delayed type hypersensitivity and massive IL-2 release. Successful dexamethasone therapy confirms this observation.
Zdziarski
Przemysław
P
Katedra i Klinika Chorób Zakaźnych Akademii Medycznej we Wrocławiu. P.Zdziarski@pharmanet.com.pl
Simon
Krzysztof
K
Majda
Jacek
J
D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001500:BCG Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D003907:Dexamethasone / Q000627:therapeutic use; D006801:Humans; D008297:Male; D013262:Stevens-Johnson Syndrome / Q000188:drug therapy / Q000209:etiology*
D000893:Anti-Inflammatory Agents; D001500:BCG Vaccine; D003907:Dexamethasone