Severe Eye Complications from Stevens-Johnson Syndrome in a Human Immunodeficiency Virus–Infected Patient in Malawi

Stevens-Johnson syndrome (SJS) is a severe form of erythema multiforme that primarily affects skin and mucous membranes. In Malawi, manifestations of SJS may become more common in human immunodeficiency virus–infected patients receiving nevirapine-based antiretroviral therapy (ART) because the CD4 cell threshold for starting ART has increased from 250 to 350 cells/μL. We describe a patient with severe ocular complications from SJS that developed soon after initiation of nevirapine-based ART and cotrimoxazole preventive treatment, which led to blindness. We draw attention to preventive measures that can potentially reduce permanent ocular damage from SJS.