Toxic epidermal necrolysis (TEN) is a devastating full-thickness epidermal exfoliative disease caused by an inciting medication.1 Clinical evidence of the disease usually presents 1 to 2 weeks after administration of the inciting medication. However, upon reexposure to a medication that previously caused TEN or exposure to a structurally related compound, the subsequent reaction is fulminant, is more severe, and may occur after the first dose.2 Although TEN has been documented after exposure to quinolones, the incidence is very low.3