Stevens-Johnson Syndrome and Hyperbaric Oxygen Therapy: A Case Report

Year 2008, Volume: 2008 Issue: 2, 164 - 168, 01.02.2008

Emrullah Solmazgül Emrullah Solmazgül Günalp Uzun Şenol Yıldız Şenol Yıldız Ahmet Şen Ahmet Akın Savaş Çekmen Emine Kara

Abstract

A 20-year-old male patient was admitted to emergency department with complaints of being unable to swallow and urinate and wounds in his hands, feet, mouth and penis. He had purulent conjunctivitis, hyperemia in nasal mucosa, pseudomembranous stomatitis in his mouth, inflammation in external urethral orifice, vesiculobullous lesions in both hands and feet. Nikolsky sign was positive. The patient was diagnosed as Stevens- Johnson syndrome and hospitalized in intensive care unit. Intravenous fluid replacement treatment, ceftriaxone sodium, ranitidine, nystatin and methylprednisolone were started. In addition, he received five sessions of hyperbaric oxygen therapy (at 2.5 atmospheres absolute for 90 minutes/day). The lesions were markedly improved after three days and he was completely healed after five days of treatment. In this case report, the potential role of hyperbaric oxygen therapy in the treatment of cutaneous and mucosal manifestations of Stevens-Johnson syndrome was discussed. Turkish Başlık: Stevens-Johnson Sendromu ve Hiperbarik Oksijen Tedavisi: Bir Olgu Sunumu Anahtar Kelimeler: Stevens-Johnson sendromu; stomatit; hiperbarik oksijenasyon; vezikülobüllöz Yirmi yaşında bir erkek hasta iki gün önce başlayan tükürüğünü yutamama, idrar yapamama, ellerde, ayaklarda, ağızda ve peniste yara şikayetleri ile acil servise başvurdu. Her iki gözde pürülan konjunktivit, burun mukozasında hiperemi, ağızda erode, psödomembranlı, yer yer kanamalı stomatit vardı. Üretra çıkışı inflamasyonluydu. Her iki el ve ayakta hedef tarzı vezikülobüllöz lezyonlar vardı. Hastada Nikolsky bulgusu pozitifti. Hastaya Stevens-Johnson sendromu tanısı konularak yoğun bakıma yatırıldı. Hastaya intravenöz sıvı replasman tedavisi, seftriakson sodyum, ranitidin, nistatin ve metilprednizolon başlandı. Bu tedavilere ek olarak 2.5 mutlak atmosfer basınçta 90 dakika/gün, toplam beş seans hiperbarik oksijen tedavisi uygulandı. Üçüncü günde hastanın belirtilerinde fark edilir düzelme gözlendi. Beş günlük tedavi sonunda hasta tamamen iyileşti. Bu olgu sunumunda hiperbarik oksijen tedavisinin Stevens-Johnson sendromunda görülen cilt ve mukoza bulgularının tedavisindeki rolü tartışılmaktadır.

Keywords

Stevens-Johnson syndrome; stomatitis; hyperbaric oxygenation; vesiculobullous

Stevens-Johnson Sendromu ve Hiperbarik Oksijen Tedavisi: Bir Olgu Sunumu

Abstract

Yirmi yaşında bir erkek hasta iki gün önce başlayan tükürüğünü yutamama, idrar yapamama, ellerde, ayaklarda, ağızda ve peniste yara şikayetleri ile acil servise başvurdu. Her iki gözde pürülan konjunktivit, burun mukozasında hiperemi, ağızda erode, psödomembranlı, yer yer kanamalı stomatit vardı. Üretra çıkışı inflamasyonluydu. Her iki el ve ayakta hedef tarzı vezikülobüllöz lezyonlar vardı. Hastada Nikolsky bulgusu pozitifti. Hastaya Stevens-Johnson sendromu tanısı konularak yoğun bakıma yatırıldı. Hastaya intravenöz sıvı replasman tedavisi, seftriakson sodyum, ranitidin, nistatin ve metilprednizolon başlandı. Bu tedavilere ek olarak 2.5 mutlak atmosfer basınçta 90 dakika/gün, toplam beş seans hiperbarik oksijen tedavisi uygulandı. Üçüncü günde hastanın belirtilerinde fark edilir düzelme gözlendi. Beş günlük tedavi sonunda hasta tamamen iyileşti. Bu olgu sunumunda hiperbarik oksijen tedavisinin Stevens-Johnson sendromunda görülen cilt ve mukoza bulgularının tedavisindeki rolü tartışılmaktadır.

Keywords

Stevens-Johnson sendromu, stomatit, hiperbarik oksijenasyon, vezikülobüllöz.

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