Case Report

Toxic Epidermal Necrolysis as a Complication of Treatment with Voriconazole

Authors: David B. Huang, MD, MPH, Jashin J. Wu, MD, Christopher J. Lahart, MD

Abstract

An 81-year-old female received voriconazole in a 7-day treatment course for a symptomaticCandida krusei urinary tract infection. Four days after the last dose, she developed toxic epidermal necrolysis. She was treated with intravenous immunoglobulin, and her symptoms promptly resolved.


Key Points


* The most common mucosal membranes involved in toxic epidermal necrolysis (TEN) are, in order of decreasing frequency, the oropharynx, eyes, genitalia, and anus.


* Voriconazole is not known to be a medication commonly associated with TEN.


* The most commonly reported voriconazole-related adverse events include elevation in hepatic transaminases or bilirubin, skin rash, abnormal vision, and a photosensitivity reaction.


* TEN should be strongly considered in individuals receiving voriconazole with temporally related characteristic lesions of the skin and mucous membranes, since this disorder can cause considerable morbidity and mortality.

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