Stevens-Johnson Syndrome associated with Mycoplasma pneumoniae infection
HSV IgG (EIA) negative. HSV IgM (EIA) positive at 3.46, normal less than 0.9. HSV DFA negative. Tzanck preparation neg. Mycoplasma IgG titer 256, normal less than 32. Mycoplasma IgM titer 128, normal less than 16. One to two doses of Ceclor and two 500 mg doses of azithromycin. Otherwise, no medications and no known drug allergies. He complained of "cold sores" and "swollen lips" one day prior to beginning Ceclor. The patient was treated with Solu-Medrol 30 mg IV QI2 hours. This dose was continued for three days, and he was then changed to prednisone 60 mg once daily which was tapered over 14 days. All antibiotics were held. Local supportive care to the hemorrhagic erosions over his lips and to the bullae over his penis was continued throughout his one-week hospital stay. The patient had a good response even after one day of Solu-Medrol. Slowly his targetoid lesions faded, and his mucosal lesions healed. 17 days following initial presentation, he returned to school.
