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Stevens-Johnson syndrome: A painful misdiagnosis

 Stevens Johnson syndrome: A painful misdiagnosis

Shanelle Logan, 19, thought she had a case of pinkeye, but when she woke up one morning and her lips felt like they were covered in blisters, she knew something else was wrong.

Shanelle told her mom, Sharon, what was wrong, and Sharon gave her some Benadryl, assuming it was an allergic reaction.

When her symptoms got worse Sharon took her daughter to the emergency room.

A week later, Shanelle found herself in the intensive care unit at Parkland Hospital in Dallas and on a feeding tube because her mouth was almost swollen shut, her throat covered in burn-like sores and her eyes sealed shut.

Stevens-Johnson syndrome, a rare condition, took over Shanelle’s hands, feet, lips, mouth, throat, chest, back and throughout her body internally.

The reaction is distinguished by burn-like sores covering the body and even affecting internal organs.

The syndrome attacks the body’s mucous membranes, causing a painful red or purple rash that spreads and blisters, eventually causing the top layer of skin to die and shed.

Stevens-Johnson syndrome, or erythema multiforme, is a skin disorder caused by an allergic reaction or infection. The condition can be fatal if not treated properly.

Generally, Stevens-Johnson syndrome is caused by an allergic reaction to a medication and not from an infection.

Medicines that can cause Stevens-Johnson syndrome include barbiturates, antibiotics (penicillins), anticonvulsants, sulfonamides and nonsteroidal anti-inflammatory drugs like aspirin, ibuprofen and naproxen sodium.

Treatments are available, but because of the severity of her condition and an early misdiagnosis, Shanelle could not be treated — only given supportive care.

Shanelle’s case began Sept. 18, the day her mom took her to a local emergency room. Sharon told the nurse in the ER she thought Shanelle was having an allergic reaction and showed her the antibiotics she was taking.

After a series of tests, she was sent home with a different antibiotic and was told she had a kidney infection, pinkeye and an irregular heartbeat with a low-grade fever — all early symptoms of Stevens-Johnson syndrome.

Sharon believes if doctors at the hospital had known what to look for, Shanelle’s case could have been treated and not become so severe.

Pinkeye is commonly mistaken in patients with Stevens-Johnson syndrome because of the blistering of the eye.

Two days later, her symptoms were worsening. Shanelle couldn’t eat or swallow and was running a high fever, so Sharon took her to see a different doctor, who told them Shanelle had Stevens-Johnson syndrome and needed to be admitted to the hospital immediately.

“She was definitely in pain,” Sharon said. “Everything else got worse.”

Shanelle was care-flighted Sept. 23 to Parkland Hospital, where she spent 12 days in intensive care.

“Because they didn’t get Shanelle when it first began, it was too late to give her the medicine they had to help her with that. so now we’re just at the point where it’s supportive care.”

The Logans had to wait for the reaction to run its course through her body and hope for the best — a very tough thing for a mother to do. Shanelle doesn’t remember most of the events, including being care-flighted to the hospital in Dallas.

“She had been in pain for so long, you could tell she had grown very weary. Everything was all about waiting and being patient, so I had to do a lot of praying,” Sharon said. “You could see what was going on on the outside, but you couldn’t see what was going on inside Shanelle’s body. About the only thing they had that was stable was Shanelle’s breathing.”

She had emergency surgery scheduled to open her eyes to try to prevent her from potentially being left blind, but because her breathing was the only thing stable about her condition, doctors decided to wait.

Shanelle has made an almost full recovery. she still can’t do things she enjoys, such as running, because of the condition, Shanelle must stay indoors and has a cream she must apply if she wants to be outside for any period of time. Her vision is still a little blurry and she may need glasses.

She has also had to take medical leave from Wayland Baptist University, where she attends college for criminal justice. However, Stevens-Johnson syndrome has inspired Shanelle to seek after a nursing degree as well.

“I still want to do criminal justice, but I also want to go into the nursing field,” she said.

Shanelle will have to maintain regular doctor visits in Dallas once a week for a year. she is seeing a dermatologist, opthamologist and gynecological doctors.

The reaction could happen again if Shanelle takes any of the medications that cause Stevens-Johnson syndrome.

The Mayo Clinic advises anyone with the following signs or symptoms to seek emergency medical care: unexplained widespread skin pain, facial swelling, blisters on skin and mucous membranes, hives, tongue swelling, a red or purple skin rash that spreads, and shedding of skin.

“Doctors say the cases are increasing. we need to get more familiar, more educated on the signs of Stevens-Johnson,” Sharon said.

Sharon hopes Shanelle’s misfortune with Stevens-Johnson syndrome will make people more aware of the signs and symptoms and doctors more knowledgeable about the syndrome. she hopes their story saves someone else from going through the same events.

Stevens-Johnson syndrome: A painful misdiagnosis

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