Reactivation of cytomegalovirus in a patient with stevens-johnson syndrome-toxic epidermal necrolysis.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are severe adverse cutaneous reactions to drugs. We describe the case of a 19 year old patient with SJS/TEN overlap syndrome, who developed severe interstitial pneumonia after she had received antiepileptic drugs. A cytomegalovirus infection was diagnosed by Real Time Polymerase Chain Reaction (RT-PCR) detection on Bronchoalveolar lavage. Based on observations on biological data, temporal relationship, and clinical features, it could be inferred that the reactivation of cytomegalovirus with viral replication can predispose a person to TEN-SJS. We discuss here, in the light of the current literature, the probable association between drug-induced SJS-TEN and fulminant reactivation of cytomegalovirus.

Factors influencing uptake of influenza vaccine amongst healthcare workers in a regional center after the A(H1N1) 2009 pandemic: lessons for improving vaccination rates.

BACKGROUND: Vaccination of health-care workers (HCWs) against seasonal influenza has been consistently recommended worldwide in order to prevent nosocomial transmission and ensure delivery of health-care services during outbreaks. Overall, immunization rates were low across all nation, including among HCWs. Little is known about the acceptability and compliance with seasonal influenza vaccine among HCWs after the A(H1N1) 2009 pandemic. PARTICIPANTS AND SETTING: Between 1st and 31 January 2011, we conducted a questionnaire-based survey at the Ibn Sina regional center (Rabat, Morocco). Seven hundred twenty one HCWs have answered about their influenza immunization during the 2010/2011 season, as well as the reasons for accepting or declining this vaccine. Finally, we compare our results with previous moroccan survey. RESULTS: A total of 122 HCWs (17%) reported having received the 2010/2011 seasonal vaccine; "self-protection" and "protection of the patient" were the most frequently adduced reasons for acceptance of the influenza vaccination, whereas media controversy during the pandemic was the main argument for refusal. DISCUSSION: The post pandemic seasonal influenza vaccination coverage among the HCWs in our institution was very low. The role of media, specific attitudinal barriers and misconceptions about immunization in a global pandemic scenario is clear. The nearly constant media coverage of the A (H1N1) 2009 pandemic, reported with varying degrees of accuracy, and sometimes portraying dramatic scenarios caused some to question whether unnecessary alarm and public panic resulted. We suggest that international or national health authorities have a clear speech over looked media and to own these institutions, which will air fair and real time information about the disease.