When 28-year-old Kalyan resident Heena Khan took a seemingly harmless antibiotic for cough and cold, seldom did she know that she will be battling for her life in hospital a day later.
Khan has been in Saifee Hospital, Charni Road, for the past 10 days. She has contracted what's called Stevens Johnson or Toxic Epidermal Necrolysis Syndrome (TENS), which has led to an adverse drug reaction causing her skin to burn from inside out and peel off.
On November 21, when Khan contracted cough and cold, a family physician prescribed a dosage of penicillin-based antibiotic Mox 250.
"In less than 48 hours, blisters erupted inside her mouth. Her skin broke and bubbles erupted on her skin," said Mustaqeem, Khan's husband. Her condition is still critical. "We cannot comment on her recovery until her skin comes back again and she starts healing. Body skin is the greatest protection from infections. If there's no skin, the underlying areas of the body are directly exposed to infections," said Dr Hakim Pardawalla, consulting physician at Saifee.
"We are replenishing her with fluids, so she is well hydrated." he said. Dr Pardawalla says he sees three to four cases of TENS every year. It's a rare disorder in which drug reaction causes the patient's skin to burn from the inside. It hits one in a given population of 1 lakh.
Close to 50% TENS patients succumb to burn injuries. Doctors said that life-threatening burns due to extreme drug reaction affect the organs lined with mucous membranes including corneas, inside of mouth, nose, anal and vaginal areas.
"TENS patients have to be kept in strict isolation. Their dead skin is carefully removed and loose gauze dressing is applied with antibacterial agents everyday for nearly three weeks," said Dr SM Keswani, a burns expert from National Burns Centre, Airoli, Navi Mumbai. Loss of vision may follow as an after-effect in some patients.
Mustaqeem has filed a police complaint against Dr Satish Bhoite, an MBBS doctor from Kalyan who prescribed Khan the medicines at Bazar Peth police station in Kalyan. "I cannot bear looking at my wife in such a state. She is in intense agony. We are feeding her liquids through spoon. Our two children, daughter Araviya (7) and son Zaid (3) are missing their mother," he said. Mustaqeem runs a small business.
Stevens Johnson Syndrome or Toxic Epidermal Necrolysis is a severe allergic drug reaction. It is a rare disorder with incidence rate of one in population of 1,00,000. It causes painful blistering of the skin and internal organs lined with mucous membrane to burn from inside out. In many cases it is preceded with flu like symptoms and high fever. As it evolves the skin literally sloughs off.
Severe conjunctivitis and loss of vision can also occur as it affects the cornea of the eyes adversely. Almost any drug can cause SJS/TEN, including over the counter drugs. TENS is mostly caused due to adverse effect of anti-epileptic drugs or anti-convulsants, HIV drugs, penicillins, corticosteroids amongst others.
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