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1. Suspect SJS or TEN
2. 1-7 cases per million patients
3. Discontinuing cream, fluid resuscitation, topical/oral antihistamines, keep room temp between 77-82 degrees F, poss transfer to a burn unit,
4. Experimental research with a control group, and experimental group, longitudinal research to see if a certain Tx helps patients over time

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1. Steven Johnson's syndrome
2. Very rare, SJS is estimated 1.0 to 6.0 cases per million
3. Symptomatic treatment;wound care, correction of electrolyte disturbances,- hydration, maintenance of appropriate urine output , pain control, prevention of sepsis, and possible tapering dose of prednisone 1-4 mg QD for 7-60 days (average of 23 days), anti-infection therapy
4. Randomized control trials; systematic review, meta-analysis

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1. We suspect it is Steven Johnson's Syndrome. It is caused by adverse reaction to the tetracycline.
2. The phenomenon is very rare
3.  The patient should immediately stop the causative agent. The patient should be admitted in a burn unit or specialized unit. The nurse should perform supportive care, infection prevention, and appropriate wound management. Pain management is also important.

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We suspect SJS/TEN as a reaction to the tetracycline.  It's pretty rare 1-7 cases per million/year.
Treatments include supportive care, including skin barriers such as those with severe burns.  Monitor the urine output, catheter may be required, oral rinses to treat vesicles,  fluids.  Randomized controlled trial and meta-analysis would be most effective designs to research therapy

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-Per the literature, the issue with our young patient seems to  be suffering from Stevens-Johnson Syndrome/ Toxic Epidermal Necrolysis
-This is listed as a side effect of use of tetracycline, which we know our patient has been using
-Very rare, and life threatening
-0.4-1.6 cases per million
-Fluids, fever reduction, IV fluids
-Place catheter and make sure urine output is keep at a high level
-Keep room temperature between 77 and 82 degrees F
-Need to get a specialist to discuss further treatment; steroid course is an option, but is somewhat controversial
-While reviewing existing research, we want to look for randomized trials

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Adverse reaction/hypersensitivity from tetracycline (common side effects include fever, rash, etc).

LOTS of articles detailing side effects.

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-What is going on? We suspect an ADR known as Stevens-Johnson Syndrome
-most often seen in children and young adults
-How Common? incidence of 1.2-6 million per year
-EBP Treatment: we advise stopping the medication, preventing further infection, increasing caloric intake, and warming the environment
-Most Pertinent Research Design: case-control study

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We suspect an infection due to elevated WBC count
Or condition could be an adverse reaction to his medication (or a combination of both medication and infection)

Steven Johnson's Syndrome -- (this is considered rare)  but adverse reactions to tetracycline IS common
Treatment: topical treatments for lesions, extensive damage can require care on a burn unit

Steroids are a good immediate response for younger patients with the condition

Condition is considered  an allergy for the patient and could potentially affect first-degree family members

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Suspect: Steven Johnson Syndrome

How common: 1 to 7 cases per million every year (rare)

Nursing Treatments/ care: renal replacement, infection therapy, symptomatic treatment, high-dose glucocorticoid treatment, skin care for blisters (keep skin clean, remove secretions, and blood clots), daily eye care and assessment of the eye, mouthwash for mouth sores, monitor for sepsis, antibiotics if infection occurs, adequate intake of nutrition

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differential diagnosis- measles, Steven Johnson syndrome
diagnosis- Steven Johnson syndrome
-very rare, less than 20,000 cases
treatments- immediate medial attention, treatments are very diverse, treat symptoms, antibiotic

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1st article - most frequently caused by other drugs. rash is more common in TEN
combination of infections and drugs for both
The incidence of TEN is estimated at 0.4 to 1.2 cases per million person-years, while SJS is
estimatedat 1.0 to6.0 cases permillion person-years.
3rd articles -
Patients presenting with symptoms suggestive of SJS, TEN, or SJS–TEN overlap should
receive an extensive history of present illness
and physical examination. General management of adult and pediatric populations focuses on supportive care and resembles that
of a high-grade burned patient, with attenuation of the catabolic state, application of
nonadherent protective barriers, and maintenance of appropriate urine output and other
organ systems representing the focus of initial care. Although supportive care represents
the principle of SJS and TEN management, addressing the causative cause is paramount in
halting progression of the disease.