We report a case of rapidly progressive bronchiolitis obliterans, which developed 24 days after the onset of Stevens-Johnson syndrome, at a time when steroid therapy-had produced resolution of most of the acute mucocutaneous lesions. The outstanding finding in this case was the obliteration of larger bronchi than are usually affected in bronchiolitis obliterans. This unusual case had pathologic findings suggesting a close relationship between the bronchial obstruction and Stevens-Johnson syndrome.
A previously healthy 41-year-old woman developed fever, generalized fatigue, and mild conjunctiv itis on July 19, 1985. She visited her local clinic and was treated with oral ampicillin — buy ampicillin, intravenous cephamandole, and anti-inflammatory agents. The next morning, she developed a diffuse erythematous macropapular rash on her back and was transferred to the ICU of Jichi Medical School Hospital at Tochigi in Japan.
On admission, the patients blood pressure was 110/60 in in Hg, her temperature was 39.0°C, and her respirator) rate averaged 30/ min. Erythematous dermal lesions associated with blisters in several places were observed on the face, thorax, back, arms, and legs.