Yonsei Med J.  2012 Jan;53(1):228-230. 10.3349/ymj.2012.53.1.228.

Toxic Epidermal Necrolysis with Ocular Involvement Following Vaccination for Hemorrhagic Fever with Renal Syndrome

• Hwang YH
• Kang MS
• Lim KO
• Lee SM

• KMID: 1779712
• DOI: http://doi.org/10.3349/ymj.2012.53.1.228

Abstract

We report a case of toxic epidermal necrolysis with ocular involvement following vaccination for hemorrhagic fever with renal syndrome. A healthy 20-year-old male soldier presented with confluent purpuric and erythematous dusky red macules evolving to flaccid blister and epidermal detachment on the whole body with conjunctival injection. The patient had no antecedent medical or surgical conditions except for two doses of hemorrhagic fever with renal syndrome vaccination. With supportive care, skin lesions were improved. Ophthalmic examinations revealed conjunctival injection with epithelial defects in both eyes. Ocular complications were resolved after amniotic membrane transplantation. Toxic epidermal necrolysis may be considered as a possible complication of hemorrhagic fever with renal syndrome vaccination.

Keyword

Hemorrhagic fever with renal syndrome; toxic epidermal necrolysis; vaccination

MeSH Terms

Conjunctival Diseases/*etiology
Epidermal Necrolysis, Toxic/*etiology
Hemorrhagic Fever with Renal Syndrome/*prevention & control
Humans
Male
Severity of Illness Index
Viral Vaccines/*adverse effects
Young Adult

Figure

• 

  Fig. 1 Photograph of the patient at the first visit. Confluent purpuric and erythematous dusky macules evolving to flaccid blister and epidermal detachment on the whole body predominating the trunk and upper limbs with extensive erosions and necroses of the lower lip were shown.

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  Fig. 2 Slit-lamp biomicroscopic finding of the right eye at the first visit. Conjunctival injection with widespread epithelial defects (area between arrows) was revealed.

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