Cotrimoxazole Induced Toxic Epidermal Necrolysis: A Clinical Case

Abstract

We present the case of a 53-year-old man, with no relevant personal medical history who was on the seventeenth day of treatment with cotrimoxazole after a diagnosis of a urinary tract infection.

He was admitted to the emergency department complaining of a pruritic maculopapular rash that was widespread, with particular emphasis on the torso and sparing the palms of the hands and soles of the feet, bilateral conjunctival hyperemia, lip edema, and odynophagia.

After an extensive study was conducted, the conclusion was that it was a side effect of the ongoing treatment, and the antibiotic was promptly suspended. However, the skin and mucosal lesions progressed unfavorably, with an increase in the affected area and an important involvement of the oral and ocular mucosa with extensive erosions. The diagnosis of toxic epidermal necrosis was made, a rare entity that occurs as a side effect of commonly prescribed antibiotics and other drugs.