Severe Stevens-Johnson Syndrome Induced by Antibiotic Therapy: A Case Report

Background: Stevens–Johnson Syndrome is a rare but life-threatening hypersensitivity reaction commonly triggered by medications, especially antibiotics. It is characterized by widespread skin lesions, mucosal ulceration, and epidermal detachment requiring urgent medical management. Case Presentation: A 34-year-old female developed high-grade fever, painful erythematous rash, oral ulcerations, conjunctival redness, and skin peeling following cotrimoxazole therapy prescribed for urinary tract infection. Dermatological examination revealed positive Nikolsky sign and epidermal detachment involving approximately 12% body surface area. Laboratory investigations showed leukocytosis and elevated inflammatory markers. Based on clinical findings and temporal association with drug exposure, a diagnosis of antibiotic-induced Stevens–Johnson syndrome was established. The offending medication was immediately discontinued, and the patient was treated with intravenous fluids, corticosteroids, antihistamines, wound care, nutritional support, and ophthalmic management. Progressive clinical improvement was observed with complete recovery after 14 days of hospitalization. Conclusion: Early recognition of Stevens–Johnson syndrome and prompt withdrawal of the causative drug are crucial for reducing morbidity and mortality. Careful antibiotic prescribing and patient awareness regarding adverse drug reactions remain essential for preventing severe complications.