Azithromycin-Induced Stevens-Johnson Syndrome in a Patient With SARS-CoV-2 and End-Stage Renal Disease.

Publication date: Aug 01, 2025

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are a spectrum of immune-mediated mucocutaneous injuries often due to an adverse reaction to medication or infection. Numerous medications have been associated with SJS, with abacavir, allopurinol, aromatic antiepileptic drugs, minocycline, proton pump inhibitors, and sulfasalazine being the most common. Additionally, there have been several case reports of SJS associated with SARS-CoV-2 infection. The clinical presentation of SJS usually includes atypical targets or purpuric macules, along with oral mucosal involvement. Herein, we present a case of SJS with primary oral mucosal involvement in a patient with end-stage renal disease (ESRD) due to polycystic kidney disease, recent SARS-CoV-2 infection, and azithromycin exposure.

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Concepts	Keywords
Kidney	drug reaction
Necrolysis	end-stage renal disease
Proton	macrolide
Stage	sars-cov-2
Toxic	stevens-johnson syndrome

Semantics

Type	Source	Name
drug	DRUGBANK	Azithromycin
disease	MESH	Stevens-Johnson Syndrome
disease	MESH	End-Stage Renal Disease
drug	DRUGBANK	Pentaerythritol tetranitrate
disease	MESH	infection
drug	DRUGBANK	Abacavir
drug	DRUGBANK	Allopurinol
drug	DRUGBANK	Minocycline
drug	DRUGBANK	Sulfasalazine
disease	MESH	SARS-CoV-2 infection
pathway	REACTOME	SARS-CoV-2 Infection
disease	MESH	polycystic kidney disease
pathway	REACTOME	Reproduction
disease	MESH	adverse drug reactions
disease	MESH	death
disease	IDO	immunodeficiency
disease	MESH	hematological malignancies
disease	MESH	cancers
disease	MESH	systemic lupus erythematosus
pathway	KEGG	Systemic lupus erythematosus
disease	MESH	tuberculosis
pathway	KEGG	Tuberculosis
disease	MESH	chronic kidney diseases
drug	DRUGBANK	Sulfamethoxazole
drug	DRUGBANK	Sulfadiazine
drug	DRUGBANK	Phenytoin
drug	DRUGBANK	Phenobarbital
drug	DRUGBANK	Carbamazepine
drug	DRUGBANK	Nevirapine
drug	DRUGBANK	Tenoxicam
drug	DRUGBANK	Meloxicam
drug	DRUGBANK	Piroxicam
drug	DRUGBANK	Lamotrigine
disease	MESH	blister
disease	IDO	history
disease	MESH	immune thrombocytopenia
drug	DRUGBANK	Tamoxifen
disease	MESH	iron deficiency anemia
disease	MESH	aphthous stomatitis
disease	MESH	mouth ulcers
drug	DRUGBANK	Famotidine
drug	DRUGBANK	Lisinopril
drug	DRUGBANK	Omega-3 fatty acids
disease	MESH	sore throat
drug	DRUGBANK	Phencyclidine
drug	DRUGBANK	Methylprednisolone
disease	IDO	intervention
disease	MESH	emergency
disease	IDO	blood
disease	MESH	erythema
disease	MESH	ulcers