If you are among those who casually pop an over-the-counter (OTC) pill for every fever, body ache or throat infection, then you may want to hear the story of Sanjeev Kumar — a 65-year-old man who learnt the lesson in the harshest possible way.
A few tablets taken without prescription for fever and body ache triggered a catastrophic immune reaction that left his skin peeling away, his eyes at risk of permanent damage, and doctors battling to save him in intensive care for nearly three weeks.
By the time Sanjeev Kumar reached the emergency department, nearly half of his body surface had been affected. Painful rashes had rapidly progressed into extensive blistering and skin detachment involving not just the body, but also the mouth, eyes and genital mucosa.
Doctors diagnosed him with Toxic Epidermal Necrolysis (TEN), one of the most severe forms of Stevens-Johnson Syndrome (SJS) — a rare but potentially fatal drug-induced hypersensitivity reaction in which the body’s immune system attacks its own skin and mucous membranes.
“In many ways, it behaves like a severe internal burn injury,” said Dr. Vikramjeet Singh, Senior Consultant, Internal Medicine, at Aakash Healthcare. “The skin barrier collapses completely, leaving the body exposed to overwhelming infections, dehydration and organ failure.”
According to Dr. Singh, the suspected trigger was a commonly available combination of antibiotics and painkillers consumed without medical supervision.
What followed was a race against time.
Sanjeev Kumar was immediately shifted to critical care and managed on the lines of a major burn patient. Steroids were started after dermatological confirmation of TEN. As the disease had already begun affecting his eyes, ophthalmologists performed an amniotic membrane graft to prevent permanent vision loss.
Dr. Singh said strict sterile barrier nursing became crucial because the patient had effectively lost the body’s natural protective covering against infection.
Over the next 20 days, multiple teams worked continuously to stabilise him. He developed complications including urinary infection and fluctuations in blood sugar levels due to underlying diabetes. He required broad-spectrum antibiotics, aggressive fluid resuscitation, nutritional support, and close monitoring to prevent sepsis and multi-organ failure.
“At one point, the challenge was not just the disease itself but the speed at which complications can develop,” Dr. Singh recalled. “Mortality in TEN remains very high because patients can deteriorate rapidly due to infection or organ failure. Early recognition and immediate withdrawal of the offending drug are the most critical steps.”
Gradually, the skin lesions began healing and new skin started regenerating. The infections came under control and his overall condition improved. After nearly three weeks in hospital, he was finally discharged in stable condition.
However, doctors say the incident highlights a far larger and growing public health concern — the widespread culture of self-medication in India.
From antibiotics and painkillers to anti-allergy medicines and steroids, several drugs are routinely purchased OTC without consultation. Many people assume that medicines commonly available at pharmacies are inherently safe.
“People often underestimate the risks associated with over-the-counter medicines,” said Dr. Saroj Kumar Yadav, Senior Consultant, Internal Medicine. “This case is a reminder that even a seemingly simple tablet can, in rare instances, trigger a life-threatening immune reaction. Self-medication should never be taken casually.”
However, doctors caution that even prescribed medicines can occasionally trigger adverse reactions. But such cases can usually be treated early if symptoms are recognised promptly and medical attention is sought without delay.
Doctors point out that Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis, though uncommon, are among the most feared adverse drug reactions due to their high mortality and devastating long-term consequences.
Symptoms often begin with fever, sore throat and fatigue before rapidly progressing to widespread rashes, blistering and skin peeling.
Experts stress that immediate medical attention is essential if any rash develops after starting a medication.
The consequences, they add, often continue long after discharge from hospital.
Survivors of SJS and TEN frequently live with chronic complications including visual impairment, severe dry eyes, skin scarring, nail deformities and psychological trauma. Many also develop deep anxiety and fear around taking medicines again, as has been highlighted by recent studies published in medical journals, including JAMA Dermatology.
The studies said that survivors often struggle with emotional recovery and lack structured rehabilitation support after leaving hospital.
