Stevens-Johnson Syndrome and Hyperbaric Oxygen Therapy: A Case Report

A 20-year-old male patient was admitted to emergency department with complaints of being unable to swallow and urinate and wounds in his hands, feet, mouth and penis. He had purulent conjunctivitis, hyperemia in nasal mucosa, pseudomembranous stomatitis in his mouth, inflammation in external urethral orifice, vesiculobullous lesions in both hands and feet. Nikolsky sign was positive. The patient was diagnosed as Stevens- Johnson syndrome and hospitalized in intensive care unit. Intravenous fluid replacement treatment, ceftriaxone sodium, ranitidine, nystatin and methylprednisolone were started. In addition, he received five sessions of hyperbaric oxygen therapy (at 2.5 atmospheres absolute for 90 minutes/day). The lesions were markedly improved after three days and he was completely healed after five days of treatment. In this case report, the potential role of hyperbaric oxygen therapy in the treatment of cutaneous and mucosal manifestations of Stevens-Johnson syndrome was discussed. Turkish Baslik: Stevens-Johnson Sendromu ve Hiperbarik Oksijen Tedavisi: Bir Olgu Sunumu Anahtar Kelimeler: Stevens-Johnson sendromu; stomatit; hiperbarik oksijenasyon; vezikulobulloz Yirmi yasinda bir erkek hasta iki gun once baslayan tukurugunu yutamama, idrar yapamama, ellerde, ayaklarda, agizda ve peniste yara sikayetleri ile acil servise basvurdu. Her iki gozde purulan konjunktivit, burun mukozasinda hiperemi, agizda erode, psodomembranli, yer yer kanamali stomatit vardi. Uretra cikisi inflamasyonluydu. Her iki el ve ayakta hedef tarzi vezikulobulloz lezyonlar vardi. Hastada Nikolsky bulgusu pozitifti. Hastaya Stevens-Johnson sendromu tanisi konularak yogun bakima yatirildi. Hastaya intravenoz sivi replasman tedavisi, seftriakson sodyum, ranitidin, nistatin ve metilprednizolon baslandi. Bu tedavilere ek olarak 2.5 mutlak atmosfer basincta 90 dakika/gun, toplam bes seans hiperbarik oksijen tedavisi uygulandi. Ucuncu gunde hastanin belirtilerinde fark edilir duzelme gozlendi. Bes gunluk tedavi sonunda hasta tamamen iyilesti. Bu olgu sunumunda hiperbarik oksijen tedavisinin Stevens-Johnson sendromunda gorulen cilt ve mukoza bulgularinin tedavisindeki rolu tartisilmaktadir.