Canadian Medical Association journal
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Confusional states in the elderly are not uncommon and demand a high level of diagnostic and therapeutic skills in the physician. An immediate requirement is to provide protection and care while the cause is being elucidated. ⋯ Confusion may be due to disorder in various body systems with effects on the brain, or to a primary brain disorder. Careful evaluation of general health and also of cognitive, affective and social factors is necessary to clarify diagnosis and management.
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Three cases are described in which Stevens-Johnson syndrome progressed in the course of a few days to toxic epidermal necrolysis. Trimethoprim-sulfamethoxazole, allopurinol in combination with hydrochlorothiazide, phenytoin and possibly ampicillin were implicated in the causation of the disease.