INTRODUCTION
Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are serious systemic diseases with erythema multiforme of the skin and mucosa and are characterized by a polymorphous vesicular and bullous eruption with fever triggered by drug administration or infection1. SJS causes complications in many organs, such as the liver, kidneys, and lungs, leading to treatment difficulties1,2. In particular, patients with respiratory distress can require extended treatment or have fatal outcomes2. However, there are few reports of SJS with lung lesions in children.
Acetaminophen is an antipyretic commonly used to relieve fever and associated discomfort in children. A prospective cohort study suggested that as many as 95% of children were exposed to acetaminophen by the age of 9 months3. Although not adequately recognized, acetaminophen is a drug that can easily cause SJS. Acetaminophen was reported as one of the top five most frequently administered drugs associated with SJS/TEN in Japan and the United States4,5. According to a recent review of cases of SJS/TEN and SJS/TEN overlap suspected to be associated with acetaminophen, 77.8% received supportive and symptomatic care. Systemic corticosteroids and intravenous immunoglobulin were administered to 69.4% and 44.4% of patients, respectively. The prognosis of these patients was not poor, as all patients survived, although long-term sequelae were available in only 13.9%6.
Herein, we describe a fatal case of acetaminophen-induced SJS in a child with irreversible lung lesions.