Ornidazole Induced Fixed Drug Eruption: A Case Report

Images representing: A case of fixed drug eruption induced by ornidazole involving chest, abdomen, trunk, lips and oral cavity.

Differential Diagnosis

1. Erythema multiforme
2.  Herpes simplex virus infection
3. Cellulitis Stevens–Johnson syndrome / toxic epidermal necrolysis⁵,⁶
4. Fixed drug eruptions
5.  Fixed food eruptions

DISCUSSION

Generalized bullous fixed drug eruption is rare but clinically significant, often mimicking Stevens–Johnson syndrome or toxic epidermal necrolysis⁵,⁶. Both fluoroquinolones and nitroimidazoles are documented triggers²,³. Mucosal involvement is frequent, with oral and genital erosions¹,².  Immediate withdrawal of the causative drug is essential⁷. Systemic corticosteroids, topical therapy, and antihistamines help control inflammation⁵. Pharmacovigilance reporting ensures drug safety monitoring⁷.

Management and Outcome:

Immediate withdrawal of the offending drugs, systemic corticosteroids, topical therapy, and infection prophylaxis led to stabilization

CONCLUSION

This case highlights generalized bullous fixed drug eruption as a serious adverse drug reaction requiring prompt recognition and management⁶. Differentiation from Stevens–Johnson syndrome or toxic epidermal necrolysis is crucial, with recurrence at fixed sites and pigmentation on healing as distinguishing features. Adverse drug reaction reporting remains vital for patient safety⁷.

Acknowledgment

I solemnly acknowledge institutional support from R.G. Kar Medical College and Hospital. The case report is written following all the ethical guidelines.

Conflict of Interest

The authors declare no conflict of interest.

REFERENCES

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2. Mahajan VK, Sharma NL, Sharma RC, Ranjan N. Fixed drug eruption: clinical features, causative drugs, and recurrence pattern. J Dermatol. 2005;32(12):951–7.
3. Shiohara T, Mizukawa Y. Fixed drug eruption: pathogenesis and diagnostic tests. Curr Opin Allergy Clin Immunol. 2002;2(4):317–21.
4. Sharma VK, Sethuraman G, Kumar B. Cutaneous adverse drug reactions: clinical pattern and causative agents — a 6-year series from Chandigarh, India. J Postgrad Med. 2001;47(2):95–9.
5. Roujeau JC, Stern RS. Severe adverse cutaneous reactions to drugs. N Engl J Med. 1994;331(19):1272–85.
6. Sehgal VN, Srivastava G. Generalized bullous fixed drug eruption: an overview. J Dermatol. 2007;34(6):361–6.
7. World Health Organization. Pharmacovigilance: ensuring the safe use of medicines. Geneva: WHO; 2004.