A diagnosis of Stevens-Johnson Syndrome (SJS) in a patient presenting with superficial keratitis
Purpose: To describe a case of Stevens-Johnson syndrome (SJS) diagnosed in a patient presenting with primarily ocular findings where SJS had not been initially suspected. Observations: A 23-year-old female presented with a 2 day history of bilateral eye pain, conjunctival injection, decreased visual...
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| Format: | Article |
| Language: | English |
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Elsevier
2018-09-01
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| Series: | American Journal of Ophthalmology Case Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2451993617302542 |
| _version_ | 1818178644290306048 |
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| author | Forson Chan Matthew D. Benson David J.A. Plemel Muhammad N. Mahmood Stanley M. Chan |
| author_facet | Forson Chan Matthew D. Benson David J.A. Plemel Muhammad N. Mahmood Stanley M. Chan |
| author_sort | Forson Chan |
| collection | DOAJ |
| description | Purpose: To describe a case of Stevens-Johnson syndrome (SJS) diagnosed in a patient presenting with primarily ocular findings where SJS had not been initially suspected. Observations: A 23-year-old female presented with a 2 day history of bilateral eye pain, conjunctival injection, decreased visual acuity, and photophobia in the context of a 4 day history of fever, headache, and sore throat. She was found to have bilateral superficial keratitis and treated for suspected early infectious keratitis secondary to extended contact lens wear. She returned the next day with worsening visual symptoms, a new macular rash over her upper torso, and new ulcerating lesions over her buccal and perioral tissue. The patient was diagnosed with SJS. She was successfully treated using systemic cyclosporine with antibiotics and steroid eye drops. Conclusions and importance: Ophthalmologists may be the first physicians to diagnose SJS, a life-threatening condition that can initially present with non-specific viral prodromal symptoms and ocular signs alone. This case emphasizes the importance of considering a patient's entire clinical history, especially when the presentation is atypical and the diagnosis is not obviously apparent. Keywords: Stevens-Johnson syndrome, Toxic epidermal necrolysis, Superficial epithelial keratitis, Clindamycin, Cyclosporine |
| first_indexed | 2024-12-11T20:51:15Z |
| format | Article |
| id | doaj.art-6586bdfb372a4c05a20c8eece03613cf |
| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2024-12-11T20:51:15Z |
| publishDate | 2018-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-6586bdfb372a4c05a20c8eece03613cf2022-12-22T00:51:13ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362018-09-0111167169A diagnosis of Stevens-Johnson Syndrome (SJS) in a patient presenting with superficial keratitisForson Chan0Matthew D. Benson1David J.A. Plemel2Muhammad N. Mahmood3Stanley M. Chan4Faculty of Medicine, University of British Columbia, 2329 West Mall, Vancouver, BC, V6T 1Z4, CanadaDepartment of Ophthalmology and Visual Sciences, University of Alberta, 10240 Kingsway Avenue, Edmonton, T5H 3V9, AB, CanadaDepartment of Ophthalmology and Visual Sciences, University of Alberta, 10240 Kingsway Avenue, Edmonton, T5H 3V9, AB, CanadaDepartment of Laboratory Medicine and Pathology, University of Alberta, 8440-112 Street, Edmonton, AB, T6G 2B7, CanadaDepartment of Ophthalmology and Visual Sciences, University of Alberta, 10240 Kingsway Avenue, Edmonton, T5H 3V9, AB, Canada; Corresponding author. Department of Ophthalmology and Visual Sciences, University of Alberta, Room 2306, 10240 Kingsway Avenue, Edmonton, AB, T5H 3V9, Canada.Purpose: To describe a case of Stevens-Johnson syndrome (SJS) diagnosed in a patient presenting with primarily ocular findings where SJS had not been initially suspected. Observations: A 23-year-old female presented with a 2 day history of bilateral eye pain, conjunctival injection, decreased visual acuity, and photophobia in the context of a 4 day history of fever, headache, and sore throat. She was found to have bilateral superficial keratitis and treated for suspected early infectious keratitis secondary to extended contact lens wear. She returned the next day with worsening visual symptoms, a new macular rash over her upper torso, and new ulcerating lesions over her buccal and perioral tissue. The patient was diagnosed with SJS. She was successfully treated using systemic cyclosporine with antibiotics and steroid eye drops. Conclusions and importance: Ophthalmologists may be the first physicians to diagnose SJS, a life-threatening condition that can initially present with non-specific viral prodromal symptoms and ocular signs alone. This case emphasizes the importance of considering a patient's entire clinical history, especially when the presentation is atypical and the diagnosis is not obviously apparent. Keywords: Stevens-Johnson syndrome, Toxic epidermal necrolysis, Superficial epithelial keratitis, Clindamycin, Cyclosporinehttp://www.sciencedirect.com/science/article/pii/S2451993617302542 |
| spellingShingle | Forson Chan Matthew D. Benson David J.A. Plemel Muhammad N. Mahmood Stanley M. Chan A diagnosis of Stevens-Johnson Syndrome (SJS) in a patient presenting with superficial keratitis American Journal of Ophthalmology Case Reports |
| title | A diagnosis of Stevens-Johnson Syndrome (SJS) in a patient presenting with superficial keratitis |
| title_full | A diagnosis of Stevens-Johnson Syndrome (SJS) in a patient presenting with superficial keratitis |
| title_fullStr | A diagnosis of Stevens-Johnson Syndrome (SJS) in a patient presenting with superficial keratitis |
| title_full_unstemmed | A diagnosis of Stevens-Johnson Syndrome (SJS) in a patient presenting with superficial keratitis |
| title_short | A diagnosis of Stevens-Johnson Syndrome (SJS) in a patient presenting with superficial keratitis |
| title_sort | diagnosis of stevens johnson syndrome sjs in a patient presenting with superficial keratitis |
| url | http://www.sciencedirect.com/science/article/pii/S2451993617302542 |
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