Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Overlap Induced by Trimethoprim/Sulfamethoxazole: A Case Report.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) overlap is a rare, potentially life-threatening cutaneous hypersensitivity reaction that requires prompt recognition and appropriate treatment. Drug-induced hypersensitivity reactions are commonly associated with medications such as antimicrobials, anticonvulsants, and nonsteroidal anti-inflammatory drugs. This case report describes an 18-year-old female patient who was prescribed trimethoprim/sulfamethoxazole for asymptomatic bacteriuria in a primary care setting, despite the absence of a clear clinical indication, and subsequently developed SJS/TEN overlap with epidermal detachment involving 20% of the body surface area. The patient improved after withdrawal of the offending agent and intensive supportive management and was discharged after 22 days of hospitalization. This case highlights the importance of early diagnosis and immediate drug discontinuation to improve outcomes.