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A Case of Amoxycillin-Induced Pediatric Lyell Syndrome in a Provincial Hospital in the Democratic Republic of the Congo

Received: 5 December 2023    Accepted: 26 December 2023    Published: 18 January 2024
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Abstract

Lyell syndrome is a rare and potentially fatal condition. It represents a serious cutaneous adverse drug reaction, often caused by drugs. Lyell syndrome and Steven-Johnson syndrome have an identical clinical expression and differ from each other only in the body surface area involved. They are characterized by the sudden destruction and detachment of the epidermis and mucous membranes. This is a drug allergy for which the mechanisms of onset are complex and involve many poorly understood pathophysiological factors. A 3-year-old girl presented with vulvar pruritus and a rash two days after self-medication with antibiotics and paracetamol to combat a fever. Phlyctenes and bullae then developed all over the body. The chronology of the occurrence of the signs, the spread of the lesions led to the diagnosis of Lyell syndrome. Lyell's syndrome is a rare condition and despite its low incidence, it is increasingly reported on the African continent. Although high, its mortality depends on several factors including the age of the patient, gender, and extent of lesions. Multidisciplinary collaboration and follow-up of the sequelae are crucial for the survival of the patient. Lyell syndrome is potentially fatal, but treatable with concerted management even in rural areas. The community and health workers should be warned of the potential danger of self-medication and irrational use of drugs.

Published in International Journal of Medical Case Reports (Volume 3, Issue 1)
DOI 10.11648/j.ijmcr.20240301.11
Page(s) 1-4
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Lyell Syndrome, Children, Drug-Induced Toxic Epidermal Necrolysis, Pharmacovigilance, DR Congo

References
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[3] Roujeau JC, Stern RS. Severe adverse cutaneous reactions to drugs. The New England Journal of Medicine. 1994 Nov 10; 331(19): 1272–85.
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[5] Auquier-Dunant A, Mockenhaupt M, Naldi L, Correia O, Schröder W, Roujeau JC, et al. Correlations between clinical patterns and causes of erythema multiforme majus, Stevens-Johnson syndrome, and toxic epidermal necrolysis: results of an international prospective study. Archives of Dermatological Research. 2002 Aug; 138(8): 1019–24.
[6] Duong TA, Valeyrie-Allanore L, Wolkenstein P, Chosidow O. Severe cutaneous adverse reactions to drugs. Lancet. 2017 Oct 28; 390(10106): 1996–2011.
[7] Dégboé B, Koudoukpo C, Almeida CD, Kouassi A, Nguessie C, Akpadjan F, et al. Severe Cutaneous Adverse Drug Reactions in Children: Epidemiological, Clinical and Etiological Aspects in Dermatology-Venereology Unit at National and Teaching Hospital of Cotonou. West African Journal of Medicine. 2022 May 27; 39(5): 538–42.
[8] Saka B, Barro-Traoré F, Atadokpédé FA, Kobangue L, Niamba PA, Adégbidi H, et al. Stevens-Johnson syndrome and toxic epidermal necrolysis in sub-Saharan Africa: a multicentric study in four countries. International Journal of Dermatology. 2013 May; 52(5): 575–9.
[9] Kaputu-Kalala-Malu C, Ntumba-Tshitenge O, Misson JP. Toxic epidermal necrolysis induced by phenobarbital in a Rwandan child: report of a case. The Pan African Medical Journal. 2014; 17: 202.
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[14] Broyles AD, Banerji A, Castells M. Practical Guidance for the Evaluation and Management of Drug Hypersensitivity: General Concepts. Vol. 8, Journal of Allergy and Clinical Immunology: In Practice. American Academy of Allergy, Asthma and Immunology; 2020. p. S3–15.
[15] Shanbhag SS, Chodosh J, Fathy C, Goverman J, Mitchell C, Saeed HN. Multidisciplinary care in Stevens-Johnson syndrome. Vol. 11, Therapeutic Advances in Chronic Disease. SAGE Publications Ltd; 2020.
[16] Basu S, Shanbhag SS, Gokani A, Kedar R, Bahuguna C, Sangwan VS. Chronic Ocular Sequelae of Stevens-Johnson Syndrome in Children: Long-term Impact of Appropriate Therapy on Natural History of Disease. American Journal of Ophthalmology. 2018 May; 189: 17–28.
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Cite This Article
  • APA Style

    Ngale, M., Mpengani, T., Velela, P., Mbebo, J., Kilara, T., et al. (2024). A Case of Amoxycillin-Induced Pediatric Lyell Syndrome in a Provincial Hospital in the Democratic Republic of the Congo. International Journal of Medical Case Reports, 3(1), 1-4. https://doi.org/10.11648/j.ijmcr.20240301.11

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    ACS Style

    Ngale, M.; Mpengani, T.; Velela, P.; Mbebo, J.; Kilara, T., et al. A Case of Amoxycillin-Induced Pediatric Lyell Syndrome in a Provincial Hospital in the Democratic Republic of the Congo. Int. J. Med. Case Rep. 2024, 3(1), 1-4. doi: 10.11648/j.ijmcr.20240301.11

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    AMA Style

    Ngale M, Mpengani T, Velela P, Mbebo J, Kilara T, et al. A Case of Amoxycillin-Induced Pediatric Lyell Syndrome in a Provincial Hospital in the Democratic Republic of the Congo. Int J Med Case Rep. 2024;3(1):1-4. doi: 10.11648/j.ijmcr.20240301.11

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  • @article{10.11648/j.ijmcr.20240301.11,
      author = {Mireille Ngale and Thierry Mpengani and Percy Velela and Jean-Jacques Mbebo and Tarcisse Kilara and Silva Kasereka and Gauthier Mesia and Nsengi Ntamabyaliro and Samuel Mampunza and Gaston Tona},
      title = {A Case of Amoxycillin-Induced Pediatric Lyell Syndrome in a Provincial Hospital in the Democratic Republic of the Congo},
      journal = {International Journal of Medical Case Reports},
      volume = {3},
      number = {1},
      pages = {1-4},
      doi = {10.11648/j.ijmcr.20240301.11},
      url = {https://doi.org/10.11648/j.ijmcr.20240301.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmcr.20240301.11},
      abstract = {Lyell syndrome is a rare and potentially fatal condition. It represents a serious cutaneous adverse drug reaction, often caused by drugs. Lyell syndrome and Steven-Johnson syndrome have an identical clinical expression and differ from each other only in the body surface area involved. They are characterized by the sudden destruction and detachment of the epidermis and mucous membranes. This is a drug allergy for which the mechanisms of onset are complex and involve many poorly understood pathophysiological factors. A 3-year-old girl presented with vulvar pruritus and a rash two days after self-medication with antibiotics and paracetamol to combat a fever. Phlyctenes and bullae then developed all over the body. The chronology of the occurrence of the signs, the spread of the lesions led to the diagnosis of Lyell syndrome. Lyell's syndrome is a rare condition and despite its low incidence, it is increasingly reported on the African continent. Although high, its mortality depends on several factors including the age of the patient, gender, and extent of lesions. Multidisciplinary collaboration and follow-up of the sequelae are crucial for the survival of the patient. Lyell syndrome is potentially fatal, but treatable with concerted management even in rural areas. The community and health workers should be warned of the potential danger of self-medication and irrational use of drugs.
    },
     year = {2024}
    }
    

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    AB  - Lyell syndrome is a rare and potentially fatal condition. It represents a serious cutaneous adverse drug reaction, often caused by drugs. Lyell syndrome and Steven-Johnson syndrome have an identical clinical expression and differ from each other only in the body surface area involved. They are characterized by the sudden destruction and detachment of the epidermis and mucous membranes. This is a drug allergy for which the mechanisms of onset are complex and involve many poorly understood pathophysiological factors. A 3-year-old girl presented with vulvar pruritus and a rash two days after self-medication with antibiotics and paracetamol to combat a fever. Phlyctenes and bullae then developed all over the body. The chronology of the occurrence of the signs, the spread of the lesions led to the diagnosis of Lyell syndrome. Lyell's syndrome is a rare condition and despite its low incidence, it is increasingly reported on the African continent. Although high, its mortality depends on several factors including the age of the patient, gender, and extent of lesions. Multidisciplinary collaboration and follow-up of the sequelae are crucial for the survival of the patient. Lyell syndrome is potentially fatal, but treatable with concerted management even in rural areas. The community and health workers should be warned of the potential danger of self-medication and irrational use of drugs.
    
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    Copy | Download

Author Information
  • Kimpese Health Research Centre, Evangelical Medical Institute, Kimpese, DR Congo; Clinical Pharmacology and Pharmacovigilance Unit, University of Kinshasa, Kinshasa, DR Congo; National Centre of Pharmacovigilance, Ministry of Health, Kinshasa, DR Congo

  • Department of Specialties, Otolaryngology Service, University of Kinshasa, Kinshasa, DR Congo; Medical Evangelic Institute, The Church of Christ in the Congo, Kimpese, DR Congo

  • National Centre of Pharmacovigilance, Ministry of Health, Kinshasa, DR Congo

  • Medical Evangelic Institute, The Church of Christ in the Congo, Kimpese, DR Congo

  • Clinical Pharmacology and Pharmacovigilance Unit, University of Kinshasa, Kinshasa, DR Congo

  • Dermatology Department of the Uele University Clinics, University of Uele, Isiro, DR Congo

  • Clinical Pharmacology and Pharmacovigilance Unit, University of Kinshasa, Kinshasa, DR Congo

  • Clinical Pharmacology and Pharmacovigilance Unit, University of Kinshasa, Kinshasa, DR Congo; National Centre of Pharmacovigilance, Ministry of Health, Kinshasa, DR Congo

  • Clinical Pharmacology and Pharmacovigilance Unit, University of Kinshasa, Kinshasa, DR Congo

  • Clinical Pharmacology and Pharmacovigilance Unit, University of Kinshasa, Kinshasa, DR Congo; National Centre of Pharmacovigilance, Ministry of Health, Kinshasa, DR Congo

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