OBJECTIVE To report a Steven-Johnson Syndrome case due to nevirapine in a-3 years old-girl with HIV infection.
CASE A-3 year old-girl, came to Dr. Cipto Mangunkusumo General Hospital with chief complaint of blisters on all over the body since five days before the admission. Patient was diagnosed with HIV since two months before admission and started ARV (zidovudine, lamivudine, nevirapine) since seven days before admission. Five days before admission, there were blisters on the cheek and it spread to face, arms, legs, chest, and back. She also had fever, cough, and runny nose. Her eyes became red and there were ulcer in her mouth. She also consumed other drugs such as valgancyclovir, co-trimoxazole, and n-acetylcystein. On physical examination, we found the patient was alert with normal vital signs. There were detachment on mucous of eyes, nose and mouth, chest, back, abdomen, arms, and legs. The diagnosis were HIV infection, Steven-Johnson syndrome, and CMV infection. We discontinued nevirapin and gave her methylprednisolone (0.5 mg/kgBW/day), clindamycin, eye drops, triamcinolone oral gel and other drugs were continued. She was improving on five days on admission. Nevirapine was changed to efavirenz one week after discontinuation of nevirapine. She got no hypersensitivity reaction with efavirenz.
CONCLUSION Steven-Johnson syndrome should be considered when we start treatment of HIV patients with any medications, especially nevirapine