Anesthetic Management of a Patient with Toxic Epidermal Necrolysis: A case report. |
Young Kyun Choe, Hyun Ok Nam, Jeong Han Lee, Kun Mu Lee, Soon Ho Cheong, Young Jae Kim, Chee Mahn Shin |
Department of Anesthesia and Pain Medicine, College of Medicine, Paik Hospital, Inje University, Busan, Korea. anecyk@inje.ac.kr |
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Abstract |
Toxic epidermal necrolysis (TEN) is one of the most dramatic, life-threatening cutaneous drug reaction. TEN is characterized by extensive detachment of the epidermis due to full-thickness necrosis. Because of extensive epidermal loss, these patients are vulnerable to infection, fluid loss, electrolyte imbalance, and heat loss. Anesthesiologist should attempt to prevent further skin damage and reduce complications such as pulmonary edema, renal failure, and sepsis. A 30-year-old male patient was admitted with fever and myalgia. 1 day after admission, scale, erosion, ulceration, eruption on skin and mucosa were developed.
Symptoms progressed to TEN after 5 days of admission. 6 days after admission, he developed panperitonitis due to duodenal ulcer perforation, and underwent laparotomy under general anesthesia. We report a case of a patient with TEN who received general anesthesia for laparotomy due to panperitonitis. |
Key Words:
toxic epidermal necrolysis |
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