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Tania Sofia Leano Martins, Maria Jose Oliveira and Augusto Ribeiro
Centro Hospitalar Sao Joao, Portugal
Posters & Accepted Abstracts: Pediat Therapeut
Introduction: The Stevens Johnson syndrome is a rare mucocutaneous disease with a mortality rate of approximately 5% and high morbidity with varied etiology as, exposure to drugs, infectious agents (Mycoplasma, herpesvirus and more rarely Epstein Bar), neoplastic or idiopathic. Clinical Case: Female children with five years old, previously healthy, were observed with rash papular purpuric on the face, neck, trunk and palms with bullous lesions and cheilitis/enanthem associated with fever (38�?°C) with six days of evolution. Laboratory tests showed elevation of hepatic enzymes with no leukocytosis and PCR 5 mg/L. Blood culture was negative. Serology showed cytomegalovirus IgG+/IgM-, herpes simplex virus (HSV) 1 IgG+/IgM+, HSV 2 IgG-/IgM doubtful and EBV IgM (VCA)+/IgG eraly-/ IgG (VCA and EBNA). Polymerase chain reaction for enterovirus, HSV 1/2, varicella zoster virus, mycoplasma and Chlamydia pneumoniae was negative and positive for EBV. The skin lesions kept worsening, so the hypothesized Stevens-Johnson syndrome was put and skin biopsy performed that was compatible. Transferred to the pediatric intensive care unit where after observation for dermatology immunoglobulin 1 g/kg/day were held for three days. Clinical improvement was discharged to seven days. Conclusions: The diagnosis of Stevens Johnson syndrome is clinical with histological confirmation in case of doubt. EBV although less frequent is an etiological agent to consider in children. Treatment with immunoglobulin although controversial for many years, is currently recommended and was established with clinical improvement.
Tania Sofia Leano Martins has completed her Medical Schooling from Medical School of Porto with 15 values and now is pursuing Pediatrics Specialty. She is a Trainer of advanced support of pediatric life as part of the Portuguese pediatric resuscitation group and Volunteer Teacher of pre-graduated Pediatrics practical and theory classes of Master’s degree in Medicine from Oporto Medical Schools. She has attended several courses with evaluation like 11th European Post-graduate course in Neonatal and Pediatric Intensive care. She has presented several clinical studies in national and international conferences and published in the form of book chapter themes: Tuberculosis in pediatrics age and Neutropenia in Pediatrics.