A Case of Amoxycillin-Induced Pediatric Lyell Syndrome in a Provincial Hospital in the Democratic Republic of the Congo

Abstract

Lyell syndrome is a rare and potentially fatal condition. It represents a serious cutaneous adverse drug reaction, often caused by drugs. Lyell syndrome and Steven-Johnson syndrome have an identical clinical expression and differ from each other only in the body surface area involved. They are characterized by the sudden destruction and detachment of the epidermis and mucous membranes. This is a drug allergy for which the mechanisms of onset are complex and involve many poorly understood pathophysiological factors. A 3-year-old girl presented with vulvar pruritus and a rash two days after self-medication with antibiotics and paracetamol to combat a fever. Phlyctenes and bullae then developed all over the body. The chronology of the occurrence of the signs, the spread of the lesions led to the diagnosis of Lyell syndrome. Lyell's syndrome is a rare condition and despite its low incidence, it is increasingly reported on the African continent. Although high, its mortality depends on several factors including the age of the patient, gender, and extent of lesions. Multidisciplinary collaboration and follow-up of the sequelae are crucial for the survival of the patient. Lyell syndrome is potentially fatal, but treatable with concerted management even in rural areas. The community and health workers should be warned of the potential danger of self-medication and irrational use of drugs.