Cefepime Associated With Phenytoin Induced Stevens-Johnson Syndrome

Am J Ther. 2017 Jul/Aug;24(4):e481-e484. doi: 10.1097/MJT.0000000000000520.


We describe a recent case of Stevens-Johnson Syndrome. A 49-year-old man was admitted to the Intensive Care Unit of an Anaesthesia and Resuscitation Department because of a Fournier gangrene that derived in a sepsis, ventilator-associated pneumonia, and renal failure. He was under treatment with cefepime and suffered a generalized status epilepticus, so started treatment with phenytoin. The next day he developed a "maculous cutaneous eruption in trunk and lower limbs" compatible with a Stevens-Johnson Syndrome. Stevens-Johnson Syndrome is a very severe and potentially fatal multiorganic disease, especially when present in critically ill patients, with a strong drug-related etiology, especially with antiepileptic drugs.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / adverse effects*
  • Anticonvulsants / adverse effects*
  • Anticonvulsants / therapeutic use
  • Cefepime
  • Cephalosporins / adverse effects*
  • Critical Illness
  • Fournier Gangrene / complications
  • Fournier Gangrene / drug therapy
  • Humans
  • Kidney Failure, Chronic / complications
  • Male
  • Middle Aged
  • Phenytoin / adverse effects*
  • Phenytoin / therapeutic use
  • Pneumonia, Ventilator-Associated / complications
  • Pneumonia, Ventilator-Associated / drug therapy
  • Sepsis / complications
  • Sepsis / drug therapy
  • Status Epilepticus / chemically induced
  • Status Epilepticus / drug therapy
  • Stevens-Johnson Syndrome / etiology
  • Stevens-Johnson Syndrome / therapy*


  • Anti-Bacterial Agents
  • Anticonvulsants
  • Cephalosporins
  • Phenytoin
  • Cefepime