DAPSONE HYPERSENSITIVITY SYNDROME
25yr old male
On admission chief complaint (admitted for): Fever, rash and weakness
Past H/o: On dapsone; MDT for leprosy
Treatment received before arrival: ofloxacin and other drugs
On admission vitals:
|
Temp: 98®F |
HR: 113/min |
BP:103/66 mmHg |
R/R: 20/min |
SPO2%: 98% |
|
Chest: clear |
CVS: S1S2 normal |
P/A: soft |
GE: icterus++++; rash + |
|
|
CNS: conscious oriented |
||||
Consultant: Dr Devendra Agrawal (M.B.B.S., D.N.B. Medicine)
Investigations:
(* Kindly Refer To Original Reports.)
|
DATE |
Hb |
TLC |
Platelet |
Creatinine |
RBS |
SGOT SGPT |
Bilirubin |
|
25/07/23 |
11.5 |
6,300 |
1.95 |
---- |
70 |
- |
Total-8.96 Direct-3.85 Indirect-5.11 |
|
28/07/23 |
10.6 |
11000 |
3.06 |
0.7 |
- |
178 102 |
Total-21.2 Direct-13.6 Indirect-7.6 |
|
29/07/23 |
10.7 |
15,280 |
2.91 |
|
|
104 96 |
Total-17.40 Direct-9.97 Indirect-7.43 |
|
30/07/23 |
9.9 |
15,550 |
2.65 |
0.87 |
124 |
71 90 |
Total-15.10 Direct-8.18 Indirect-6.92 |
|
30/07/23 |
9.0 |
16.500 |
2.21 |
|
|
88 130 |
Total – 14.33 Direct – 7.03 Indirect – 7.30 |
|
02/08/23 |
8.9 |
41.7 |
2.55 |
- |
- |
269 9.9 |
Total- 10.8 Direct-9.8 Indirect-1 |
|
06/08/23 |
8.0 |
9.800 |
2.33 |
|
70 |
72 221 |
Total – 13.1 Direct – 5.2 Indirect – 7.90 |
|
29/07/23 |
LDH TEST -722, HIV TEST – NEGATIVE, DENGUE TEST –NEGATIVE, MALARIAL TEST – NEGATIVE, URINE TEST – PUS CELL-2-3, CRP TEST-23.29, |
||||||
|
DATE |
Imaging |
|
28/07/23 |
USG A/P- The liver
parenchyma shows mildly reduced echogenicity, r/o parenchymal disease.
Excessive gases are seen in colonic region. No other significant abnormality
is seen in the abdomen and pelvis. |
|
28/07/23 |
XRAY CHEST PA VIEW- No
significant abnormality is seen in the chest. |
|
30/07/23 |
XRAY CHEST PA VIEW- As
compared to previous xray dated 28/07/2023, no new lesion is seen. No focal
lesion is seen. Both the pleural cavities remain clear. |
|
01/08/23 |
USG A/P- Borderline
hepatomegaly, with mild splenomegaly. Minimal right sided pleural effusion,
with mild ascites. Excessive gases are seen in colonic region. |
|
01/08/23 |
ECG- Sinus rhythm
anteroseptal T wave abnormality is nonspecitic borderline ecg. |
Treatment given:
Iv Fluids ,Inj tazomac, inj hydrocort, tab calpol, tab limcee, tab nurokind
plus, tab zincovit, tab atarax, tab avil, tab benalgis, inj ranitac, tab
wysolone, tab pan 40mg,
Course in hospital: patient was managed for dapsone hypersensitivity syndrome- fever,
exfoliative dermatitis, hepatitis. Patient had fever for 10 days. Patient is
afebrile since 3 days and taking oral diet properly. Patient responded to the
treatment. Hospitals stay uneventful. Patient condition stable on discharge.
Procedure performed: IV cannulations
Condition at time of discharge:
|
Temp: 98.6®F |
HR: 80/min |
BP: 110/70mmHg |
R/R: 20/min |
SPO2%: 97% |
|
Chest: Clear |
CVS: S1S2 normal |
P/A: soft |
||
|
CNS: conscious oriented |
||||
