A child who has been taking antibiotics is brought to the clinic with a rash. The parent reports that the child had a fever associated with what looked like sunburn and now has "blisters" all over. A physical examination shows coalescent target lesions and widespread bullae and areas of peeled skin revealing moist, red surfaces. What will the primary care pediatric nurse practitioner do?

Question

Quizplus · Accepted Answer

This child's presentation is consistent with Stevens-Johnson syndrome or toxic epidermal necrolysis, which are severe and potentially life-threatening skin reactions often triggered by medications such as antibiotics. Admission to a pediatric intensive care unit with the consultation of a pediatric intensivist is necessary for supportive care and management. Treatment may include discontinuation of the offending agent, fluid and electrolyte management, wound care, and analgesics. Acyclovir, antihistamines, and prophylactic antimicrobial medications are not indicated for the management of Stevens-Johnson syndrome or toxic epidermal necrolysis.

A Child Who Has Been Taking Antibiotics Is Brought to the Clinic