She had eagerly started her life as a member of society after getting a job at a company that she had wanted to work for. She was spending her fulfilling life every day, for example, in going to a concert of her favorite artist with her friend on a holiday. One morning, she had a fever and headache and took a fever reducer/painkiller. Then, she…

She experienced Stevens-Johnson syndrome in early summer at the age of 22 years. She had graduated from college and had started to work as a member of society a few months before.

She had a slight fever and sore throat when she got up in the morning. She though that she had a cold and took an over-the-counter fever reducer/painkiller before going to work. She had taken the drug before. The drug had not passed its expiration date, and she took it according to the predetermined dose and usage. She started to feel discomfort around the mouth during work a few hours later. She felt her lips swollen and hot.

She got up the next morning and found that she had bloodshot eyes. So, she visited an ophthalmologist. She was suspected of having viral conjunctivitis and received prescription of an ophthalmic solution. On the other hand, she still had the cold-like signs and symptoms such as fever and headache. She started to have red rash on the face and a higher fever of 39 degrees Celsius. She took the same fever reducer/painkiller again, but the fever was not reduced. She wanted to recover from cold as soon as possible and took a day off to visit a local physician. The physician told her that she probably had hand-foot-and-mouth disease, which causes similar signs and symptoms to those of cold.

She returned home from the hospital and took a rest at home. However, the fever remained between 39 and 40 degrees Celsius and did not decline. She started to have blisters in the mouth and chickenpox-like rash throughout the body. She thought that something unusual was happening and urgently visited a nighttime emergency unit of the nearest general hospital. The physician who treated her said to her, “I’ve never seen these clinical presentations before. We cannot make a diagnosis, so please visit a university hospital.” She was promptly referred to a specialist of a university hospital, where treatment was immediately started under hospitalization. The skin rash that she had had on the face and hands was noted throughout the body then. At the university hospital, she was examined by a dermatologist and told that she probably had Stevens-Johnson syndrome. She was also examined by an ophthalmologist the following day and was told that she would receive eye treatment every day for the treatment of erosion on the eye surface. She received an explanation from her attending doctor that she had been diagnosed as having Stevens-Johnson syndrome and would start to receive treatment of it. After treatment was started with drip infusion and ocular instillation, the rash started to gradually resolve, and the fever declined the next day. She became able to open her eyes easily and was discharged from the hospital a month and a half later.

She had no systemic sequelae and good visual acuity. However, she always had dryness in her eyes and could not keep them open for a while. She became unable to keep looking at the screen of a computer for hours and therefore asked her company to relocate her to another position. She said, “I never thought that the fever reducer/painkiller I casually took might cause such a horrible disease.” “I was very afraid to hear that this disease is unfamiliar to physicians. I want as many people as possible to know this disease,” she said earnestly.

Doctor's Comment

Stevens-Johnson syndrome frequently causes a fever higher than 39 degrees Celsius. Rash rapidly spreads throughout the body. If you feel something unusual, do not make a decision by your self and see a doctor. Never fail to see an ophthalmologist if you have red eyes. Bloodshot eyes sometimes precede rash and are diagnosed as acute conjunctivitis or viral conjunctivitis in some cases.

Other Case: M. T. (the-40-year-old man)