Rifampicin-induced Stevens-Johnson Syndrome: A Rare Case Report

Tuberculosis (TB) continues to be a major global health issue, necessitating effective treatment regimens primarily involving antitubercular drugs. First-line antitubercular drugs are commonly used in combination with other medications to treat TB. These drugs are essential for the treatment of TB, a contagious bacterial infection caused by Mycobacterium tuberculosis. However, antitubercular drugs can lead to various skin reactions, which may range from mild to severe. Stevens-Johnson Syndrome (SJS) is a rare and severe reaction characterised by extensive skin peeling and mucosal involvement. It can occur with any antitubercular drug but is more commonly associated with isoniazid and rifampicin. Rifampicin, an essential medication in the treatment of TB, is known for its efficacy but also for its potential to cause severe adverse reactions. The spectrum of skin reactions can vary widely, from benign rashes to Severe Cutaneous Adverse Reactions (SCARs), like SJS. Early recognition and appropriate management are crucial to mitigate complications. Understanding these adverse effects is essential not only for immediate patient care but also for fostering long-term adherence to TB treatment, as fear of side effects can lead patients to abandon their regimens prematurely. Hereby, the authors present a rare case of a 55-year-old male who developed life-threatening skin reactions, including SJS, following the initiation of rifampicin therapy. Rapid recognition and intervention were critical, leading to the immediate discontinuation of rifampicin and the initiation of supportive care and corticosteroids. The patient was closely monitored, and his condition improved significantly over the following weeks, with gradual resolution of skin lesions and restoration of mucosal integrity.