Toxic epidermal necrolysis following a furosemide injection: a case report

BACKGROUND: Toxic epidermal necrolysis is a life threatening adverse cutaneous reaction mostly following drug administration. It is characterized by extensive detachment of skin and mucous membranes with a more than 30% total body surface area involvement. We document a rare occurrence of Toxic epidermal necrolysis following a furosemide injection. CASE PRESENTATION: A one-year-old female from Eastern Uganda was referred to our facility with history of a generalized skin eruption that started 2 days after a furosemide injection. On admission, she had extensive skin sloughing involving the face, trunk and limbs with 60% total body surface area involvement. A diagnosis of Toxic epidermal necrolysis was made, and she was started on supportive care. She showed initial improvement but later the parents left the hospital against medical advice and she died from home. CONCLUSION: Furosemide a drug with structural similarities with Sulphonamide antibiotics, has been associated with the rare but life-threatening adverse reaction, Toxic epidermal necrolysis. This case report documents a possible case of Toxic epidermal necrolysis in a child following a furosemide injection to increase awareness amongst clinicians.