Pediatric Infectious Disease

Register      Login

VOLUME 1 , ISSUE 4 ( October-December, 2019 ) > List of Articles

CASE REPORT

Fuchs Syndrome: An Uncommon Entity of Stevens–Johnson Syndrome beyond Drugs

Muhammed Hafis, Kaavil V Arun, Bhaskar Shenoy

Keywords : Fuchs syndrome, Mycoplasma, Steven–Johnson syndrome

Citation Information : Hafis M, Arun KV, Shenoy B. Fuchs Syndrome: An Uncommon Entity of Stevens–Johnson Syndrome beyond Drugs. Pediatr Inf Dis 2019; 1 (4):171-173.

DOI: 10.5005/jp-journals-10081-1232

License: CC BY-NC 4.0

Published Online: 23-07-2020

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background: A rare case of atypical Steven–Johnson syndrome secondary to mycoplasma infection. Case description: An eight-year-old boy presented with a history of fever and cough of 7 days with recent-onset redness and purulent discharge of eyes with multiple oral ulcers for the past 3 days. He was febrile, toxic looking with bilateral conjunctival congestion, multiple painful ulcers in the mouth, and severe mucositis. Because of cefpodoxime ingestion before the onset of ulcers and redness of eyes, possibility of Steven–Johnson syndrome considered and history of respiratory infection in the absence of skin involvement, atypical Steven–Johnson syndrome secondary to mycoplasma infection (Fuchs syndrome) kept in mind. mycoplasma serology was sent which was reported as positive. Other routine investigations and chest X-ray were normal. Intervention: He was started on IV pulse methylprednisolone for 7 days. He becomes afebrile after the first dose of methylprednisolone. Eye lubricants and topical anti-inflammatory agents continued. A significant reduction in mucositis observed. Later oral corticosteroid continued and tapered and stopped over 2 weeks. Message: Severe mucositis with the background of respiratory infection, Fuchs syndrome should be considered as a differential.


PDF Share
  1. Mangal S, Narang T, Saikia UN, et al. Fuchs syndrome or erythema multiforme major, uncommon or underdiagnosed? Indian J Dermatol Venereol Leprol [serial online] 2015;81(4):403–405. DOI: 10.4103/0378-6323.158640.
  2. Gupta L, Martin A, Agarwal N, et al. Guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis: An Indian perspective. Indian J Dermatol Venereol Leprol 2016;82(6):603–625. DOI: 10.4103/0378-6323.191134.
  3. Sah R, Neupane S, Khadka S, et al. A Case Study of Stevens-Johnson Syndrome-Toxic Epidermal Necrolysis (SJS-TEN) Overlap in Mycoplasma pneumoniae Associated Tracheobronchitis. Infectious Diseases 2019;2019:5471765.
  4. Meyer Sauteur PM, Gansser-Kälin U, Lautenschlager S, et al. Fuchs syndrome associated with Mycoplasma pneumoniae (Stevens-Johnson syndrome without skin lesions. Pediatr Dermatol 2011;28(4):474–476. DOI: 10.1111/j.1525-1470.2010.01200.x.
  5. Thing CY, Shahdadpuri R. Fuchs syndrome: a case of fever, mucositis, and conjunctivitis. BMJ Case Reports 2018;2018:bcr2017223321. DOI: 10.1136/bcr-2017-223321.
  6. Susan DJ, Janaki R, Swischuk LE. Spectrum of clinical and radiographic findings in paediatric mycoplasma pneumoniae. RadioGraphics 2001;21(1):121–131. DOI: 10.1148/radiographics.21.1. g01ja10121.
  7. Kheiri B, Alhesan NA, Madala S, et al. Mycoplasma pneumoniae-associated Fuchs syndrome. Clin case rep 2018;6(2):434–435. DOI: 10.1002/ccr3.1350.
  8. Anders UM, Taylor EJ, Kravchuk V, et al. Stevens-Johnson Syndrome without Skin Lesions: A Rare and Clinically Challenging Disease in the Urgent Setting. Emerg Med Open J 2015;1(2):22–30. DOI: 10.17140/EMOJ-1-106.
  9. Nappe TM, Garcia SL, Jacoby JL. Stevens-Johnson syndrome after treatment with azithromycin: an uncommon culprit. Am J Emerg Med 2016;34(3):676.e1-3. DOI: 10.1016/j.ajem.2015.06.039.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.