RESUMO
Since the development of antiretroviral therapy (ART) and antibiotic prophylaxis, the incidence of opportunistic infections in human immunodeficiency virus-acquired immunodeficiency syndrome (HIV-AIDS) has been drastically reduced. However, third-world countries remain a fertile ground for medication nonadherence and inappropriate patient follow-up. Here, we present the case of a 42-year-old male with a history of HIV who presented with worsening shortness of breath and atypical chest pain. A chest X-ray and chest computed tomography scan revealed a left parahilar cavitation measuring 86 mm in diameter. A percutaneous lung biopsy revealed Pneumocystis jirovecii. Appropriate antibiotics were started, and the patient's clinical status significantly improved. This case illustrates the devastating consequences of uncontrolled HIV-AIDS. ART and prophylactic antibiotics remain the cornerstone of treatment to ameliorate progressive lung damage in patients.
RESUMO
Steven-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening mucocutaneous reactions that are predominantly drug-induced. Treatment varies depending on the severity, but even with accurate medical management, the mortality rate can be up to 50% in severe cases. Recurrent episodes with different agents are uncommon, but they have been reported in the literature. We present a case of a 30-year-old female presenting with recurrent SJS/TEN overlap syndrome complicated by sepsis after phenytoin use. Records revealed a previous episode after carbamazepine use one month prior to the current presentation and a first episode 23 years ago with an unknown medication. The offending agent was discontinued, the appropriate treatment was given, and the patient's clinical status significantly improved. This case highlights the life-threatening manifestation of a mucocutaneous reaction. Prompt clinical assessment is paramount for patient survival.
