title: HIV-Associated Toxic Epidermal Necrolysis at San Francisco General Hospital.
abstract: We sought to characterize recent cases of toxic epidermal necrolysis (TEN) in HIV-infected patients at San Francisco General Hospital (SFGH), a large HIV referral center.
  
  
  
  This was a retrospective analysis of HIV-infected patients diagnosed with TEN from January 2001 to May 2014 at SFGH.
  
  
  
  Ten cases of TEN were identified, 50% of which occurred in HIV-infected individuals. Among the HIV-associated cases, causative agents were trimethoprim-sulfamethoxazole (TMP-SMX; n = 2), atovaquone, clindamycin, and fluconazole. No antiretroviral agents were implicated.
  
  
  
  Although limited by small sample size, our experience is reflective of the well-recognized increased incidence of TEN in HIV-positive patients and suggests that antimicrobial agents, particularly TMP-SMX, are the most common causative agents in this population. As 3 of the 5 HIV-associated TEN cases were caused by potentially inappropriate or unnecessary use of antibiotics, our experience highlights the importance of judicious use of systemic medications in populations susceptible to severe adverse drug reactions.
authors.affiliation: 1 School of Medicine, University of California, San Francisco, CA, USA.
authors.forename: Jossy
authors.initials: J
authors.lastname: Tseng
authors.affiliation: 2 Department of Dermatology, University of California, San Francisco, CA, USA.
authors.forename: Toby
authors.initials: T
authors.lastname: Maurer
authors.affiliation: 3 Department of Dermatology, Temple University School of Medicine, Philadelphia, PA, USA.
authors.forename: Misha M
authors.initials: MM
authors.lastname: Mutizwa
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000188:drug therapy / Q000517:prevention & control; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D019072:Antibiotic Prophylaxis / Q000009:adverse effects; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012495:San Francisco / Q000453:epidemiology; D013262:Stevens-Johnson Syndrome / Q000150:complications / Q000453:epidemiology / Q000209:etiology; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination
keywords: AIDS; HIV; TEN; drug reaction; toxic epidermal necrolysis