Suspected Stevens-Johnson Syndrome After Azithromycin and Doxycycline Exposure in an Elderly Woman: A Case Report Showcasing Treatment Based on Clinical Diagnosis

Drug-induced cutaneous reactions can range from mild eruptions to life-threatening syndromes such as Stevens-Johnson syndrome (SJS), often presenting a diagnostic and management challenge. We present the case of a 76-year-old woman who developed a rapidly progressive, diffuse erythematous rash with systemic manifestations following sequential use of two different antibiotics for the treatment of unresolving cold symptoms. Due to the complexity of definitive medical diagnosis of severe drug-induced hypersensitivity reactions and histopathological access, treatment relied on clinical diagnosis based on findings, patient history, and symptoms. Prompt discontinuation of suspected medications and initiation of multidisciplinary supportive care resulted in significant clinical improvement, with the patient returning close to baseline prior to hospital discharge. This case highlights the diagnostic complexity of antibiotic-associated reactions and underscores the importance of early recognition and management to prevent disease progression and recurrence.