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.