Stevens-Johnson Syndrome — SCE Infectious Diseases MCQ

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ModerateAntimicrobial StewardshipStevens-Johnson SyndromeSCE Infectious Diseases

A 32-year-old woman develops fever, rash (target lesions), and mucosal involvement (oral and genital ulceration) with skin blistering affecting <10% body surface area. She was started on Co-trimoxazole 2 weeks ago for a UTI. What is the most likely diagnosis?

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Correct answer: B — Stevens-Johnson syndrome (SJS) secondary to Co-trimoxazole

Target lesions with mucosal involvement (≥2 mucosal sites) and skin detachment <10% BSA following sulfonamide exposure is classic SJS. Co-trimoxazole (Trimethoprim-Sulfamethoxazole) is one of the most commonly implicated drugs for SJS/TEN. Management includes immediate discontinuation of the causative drug, supportive care in a burns or dermatology unit, and consideration of IVIG or Ciclosporin. SJS is defined as <10% BSA detachment; TEN is >30%; overlap is 10–30%.

Reference: BAD 2023 – SJS/TEN guidelines; BNF 2024 – Co-trimoxazole adverse effects