scholarly journals Vancomycin-induced DRESS syndrome treated with systemic steroids in a 16-year-old male

2019 ◽  
Vol 7 ◽  
pp. 2050313X1984170 ◽  
Author(s):  
Dylan Maldonado ◽  
Jay Lakhani
Keyword(s):  
Drug Reaction ◽  
Marked Improvement ◽  
Treatment Guidelines ◽  
Disease Process ◽  
Steroid Treatment ◽  
Systemic Steroid ◽  
Dress Syndrome ◽  
Systemic Corticosteroids ◽  
Life Threatening ◽  
Systemic Symptoms

This is a case report of a 16-year-old patient with DRESS syndrome (Drug Reaction with Eosinophilia and Systemic Symptoms) associated with vancomycin who improved with systemic steroid treatment. DRESS syndrome is a life-threatening disease process typically secondary to medications, such as anticonvulsants, sulfonamides, and allopurinol. Vancomycin has also been associated with this condition. Apart from discontinuation of the offending agent, there are no clear treatment guidelines, but reports of improvement with systemic corticosteroids are described. We present a case of a 16-year-old male who had been on vancomycin for greater than 4 weeks before developing symptoms consistent with the diagnosis of DRESS syndrome. Our patient demonstrated marked improvement with systemic corticosteroids.

scholarly journals Vancomycin-Induced DRESS Syndrome: An Important Concern in Orthopedic Surgery

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Emma Littlehales ◽  
Odhrán Murray ◽  
Robert Dunsmuir
Keyword(s):  
Drug Reaction ◽  
Mortality Rate ◽  
Antibiotic Treatment ◽  
Orthopedic Surgery ◽  
Scoring System ◽  
Steroid Treatment ◽  
Dress Syndrome ◽  
Important Concern ◽  
Criteria For Diagnosis ◽  
Systemic Symptoms

DRESS (drug reaction with eosinophilia and systemic symptoms) is a potentially serious complication when prolonged courses of antibiotics are given to patients, with an average onset of 2–6 weeks after commencement. There is a high mortality rate (1–10%). We report the case of a 62-year-old male who developed DRESS after seven weeks of antibiotic treatment with vancomycin for a deep spinal metalwork infection. We describe the typical rash and biochemical results, including eosinophilia, as well as the systemic signs seen in this case. The criteria for diagnosis of DRESS, including the RegiSCAR scoring system and commonly affected systems (renal, cardiac, and hepatic), are detailed, and we also discuss evidence for steroid treatment and considerations important in the use of this.

scholarly journals Phenytoin induced life threatening macroglossia in a child

2013 ◽  
Vol 04 (01) ◽  
pp. 75-77 ◽  
Author(s):  
Rakesh Mondal ◽  
Sumantra Sarkar ◽  
Tapas Sabui ◽  
Partha Pratim Pan
Keyword(s):  
Drug Reaction ◽  
Hereditary Angioedema ◽  
Dress Syndrome ◽  
Medical College ◽  
Life Threatening ◽  
Systemic Symptoms

ABSTRACTIsolated acquired macroglossia of tongue rarely reported. It occurs due to causes like hereditary angioedema, localized angioedema, etc., Here we describe an 8‑year‑old boy developing life threatening localized angioedema of tongue due to phenytoin without any association with drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome or pseudolymphoma encountered in rural medical college. Anticonvulsants, that is, phenytoin induced this isolated peculiar complication, which was not described before.

scholarly journals Lamotrigine Induced DRESS Syndrome in a Child: A Case Report and Literature Review

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1063
Author(s):  
Chien-Heng Lin ◽  
Sheng-Shing Lin ◽  
Syuan-Yu Hong ◽  
Chieh-Ho Chen ◽  
I-Ching Chou
Keyword(s):  
Drug Reaction ◽  
Case Report ◽  
Skin Rash ◽  
Stable Condition ◽  
Anticonvulsant Drug ◽  
Dress Syndrome ◽  
Life Threatening ◽  
History Of ◽  
History Of Epilepsy ◽  
Systemic Symptoms

Lamotrigine is an important anticonvulsant drug. Its use, however, has been limited by the risk of potentially life-threatening dermatological reactions, such as a drug reaction with eosinophilia and systemic symptoms (DRESS). Here, we report the case of a 7-year-6-month-old girl with a history of epilepsy who developed a skin rash with dyspnoea after 2 weeks of lamotrigine treatment, with DRESS ultimately being diagnosed. After discontinuation of the offending drug and the initiation of systemic glucocorticosteroids, the DRESS symptoms were relieved and the patient was discharged in a stable condition. Anticonvulsant drugs such as lamotrigine are among the factors that induce DRESS in children. When a patient displays skin rash and systemic organ involvement following the initiation of an anticonvulsant drug, DRESS should not be overlooked as a diagnosis, and immunosuppressant drugs should be considered as an option for treating DRESS patients.

scholarly journals Drug reaction with eosinophilia and systemic symptom induced by carbamazepine: a case report

2019 ◽  
Vol 8 (5) ◽  
pp. 1115
Author(s):  
Rahul R. Damor ◽  
Amita R. Kubavat ◽  
Kiran G. Piparva
Keyword(s):  
Drug Reaction ◽  
Case Report ◽  
Antiepileptic Drugs ◽  
Drug Exposure ◽  
Latency Period ◽  
Systemic Symptom ◽  
Dress Syndrome ◽  
Period 2 ◽  
Life Threatening ◽  
Systemic Symptoms

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, potentially life-threatening acute adverse drug reaction (ADR), typically characterized by a long latency period (2-6 weeks to 3 months) from drug exposure. DRESS syndrome is defined by the presence of fever, cutaneous eruption, lymphadenopathy, systemic or asymptomatic internal organ involvement (e.g. Hepatitis, carditis, interstitial nephritis, interstitial pneumonitis, etc.) and haematological abnormalities, mainly leucocytosis, eosinophilia and sometimes atypical lymphocytosis. There are around 50 culprit drugs which cause DRESS syndrome e.g. carbamazepine, phenytoin, allopurinol, sulfa derivatives, antidepressants, antiepileptics, non-steroidal anti-inflammatory drugs and antimicrobials. The incidence of DRESS syndrome has been estimated to be between 1 in 1,000 and 1 in 10,000 drug exposures. There are many reported cases of DRESS syndrome due to carbamazepine, phenytoin, vancomycin, levitiracitam, ceftriaxone etc. Author presented a case of DRESS syndrome by carbamazepin. RegiSCAR and Japanese consensus group have developed specific criteria for making the diagnosis of DRESS syndrome. The patient described here met the majority of criteria according to RegiSCAR scoring guidelines for a diagnosis of DRESS syndrome induced by carbamazepine. As per RegiSCAR diagnostic criteria author had concluded that this was a “Definite” case of DRESS (Drug Reaction with Eosinophilia and Systemic Symptom) syndrome induced by carbamazepine. Carbamazepine is most common broad-spectrum antiepileptic drugs so, this case report will raises awareness among physician to suspect DRESS syndrome in patients who present unusual complaints and skin findings after starting antiepileptic drugs.

scholarly journals A Relapsing Case of Drug Reaction with Eosinophilia and Systemic Symptoms (Dress) Syndrome

2021 ◽  
pp. 1-3
Author(s):  
Aravind Reddy Kuchkuntla ◽  
Keyword(s):  
Drug Reaction ◽  
Hypereosinophilic Syndrome ◽  
Supportive Therapy ◽  
Chylous Ascites ◽  
Dress Syndrome ◽  
Systemic Corticosteroids ◽  
Steven Johnson Syndrome ◽  
Systemic Symptoms ◽  
Generalized Lymphadenopathy ◽  
The Individual

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe and potentially fatal adverse hypersensitivity reaction often secondary to therapeutic medications. There is a wide variation in the incidence of the disease and is dependent on the genetic makeup of the individual. The most common presentation includes skin eruptions, fever, generalized lymphadenopathy, eosinophilia, and internal organ involvement (most commonly, liver, kidneys, and lungs). Some less common features are dysphagia, agranulocytosis, and chylous ascites. The most common drugs causing DRESS syndrome include carbamazepine, allopurinol, sulfasalazine, phenobarbital, and lamotrigine. Differential diagnosis has Steven-Johnson Syndrome/Toxic Epidermal Necrolysis, hypereosinophilic syndrome, and Sezary syndrome. Systemic corticosteroids are the first-line treatment for DRESS syndrome and the withdrawal of the offending agent and supportive therapy. We report a rare case of DRESS syndrome following the use of clarithromycin and moxifloxacin, where rapid steroid taper resulted in relapse.

scholarly journals Highly Probable Drug Reaction With Eosinophilia and Systemic Symptoms Syndrome Associated With Lenalidomide

2017 ◽  
Vol 52 (6) ◽  
pp. 408-411 ◽  
Author(s):  
Anusha Shanbhag ◽  
E. Ryan Pritchard ◽  
Kshitij Chatterjee ◽  
Drayton A. Hammond
Keyword(s):  
Drug Reaction ◽  
Hemodynamic Instability ◽  
African American Female ◽  
Probability Scale ◽  
Blood Cell Count ◽  
Dress Syndrome ◽  
Peripheral Smear ◽  
Life Threatening ◽  
Systemic Symptoms

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a life-threatening hypersensitivity reaction to medications. We report a case of a 75-year-old African American female who presented with generalized rash with desquamation and malodorous secretions. She was febrile and hypotensive, and required vasopressors for hemodynamic instability. Sepsis secondary to skin or soft tissue infection was considered initially. However, she recently was started on lenalidomide for treatment of her multiple myeloma, and her white blood cell count of 17 K/µL with 55% eosinophils along with peripheral smear showing eosinophilia suggested lenalidomide-induced rash. Lenalidomide was discontinued, and methylprednisolone was initiated. Four days after lenalidomide discontinuation, vasopressors were discontinued. Blood cultures did not exhibit any growth. The Niranjo Adverse Drug Reaction Probability Scale score of 9 suggests lenalidomide was a highly probable cause of DRESS syndrome. The temporal relation of lenalidomide administration and development of symptoms plus improvement of rash with the discontinuation of lenalidomide and reappearance on restarting lenalidomide in the follow-up clinic strengthens our suspicion of lenalidomide-induced DRESS syndrome. Cases of lenalidomide-induced DRESS syndrome are sparse; however, DRESS syndrome is fatal in approximately 10% of patients. Providers should be aware and keep a vigilant eye out for this adverse reaction with lenalidomide.

scholarly journals A Ten-Year-Old Boy with Antiepileptic Drugs-Induced DRESS Syndrome

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
S. Vithana ◽  
M. H. A. D. De Silva ◽  
G. P. Hewawitharana
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Antiepileptic Drugs ◽  
Multiorgan Failure ◽  
Maculopapular Rash ◽  
Prominent Feature ◽  
Dress Syndrome ◽  
Exfoliative Dermatitis ◽  
Life Threatening ◽  
Systemic Symptoms

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a life-threatening adverse drug reaction if it is not timely diagnosed and treated. This happens probably following a cascade of immune reactions after the administration of the drug ultimately leading to multiorgan failure and death. Several groups of drugs have been identified as potential aetiologies but the commonest one identified is antiepileptic drugs. The clinical features of DRESS syndrome usually appear several weeks after commencing the offending drug. Initially, fever lymphadenopathy and rash appear followed by hepatitis. Rash is the most prominent feature, and it is a generalized erythematous nonblanching maculopapular rash without the involvement of the mucus membranes or eyes. The rash desquamated over the following days and changed it’s context to an exfoliative dermatitis. We report a case of a 10-year-old boy who is one of the twins born to nonconsanguineous parents at 34 weeks of gestation.

scholarly journals Drug reaction with eosinophilia and systemic symptoms syndrome in a patient taking lamotrigine

2019 ◽  
Vol 12 (10) ◽  
pp. e229180 ◽  
Author(s):  
Catarina Lameiras ◽  
Énia Ornelas ◽  
Marta Mendes Lopes ◽  
Maria do Céu Dória
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Late Onset ◽  
Clinical Manifestations ◽  
Multiple Organ ◽  
Dress Syndrome ◽  
Causative Drug ◽  
Life Threatening ◽  
Systemic Symptoms ◽  
Hepatic Cytolysis

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare adverse drug reaction characterised by skin eruption and multiple organ involvement. Diagnosing this entity is challenging due to the variability of clinical manifestations, late onset and relapse even after stopping the causative drug. It is potentially life-threatening; thus, it must be promptly recognised and the causative drug withdrawn. We describe a case of a 50-year-old man with an acute diffuse rash, fever and eosinophilia 4 weeks after having started lamotrigine. The suspected eliciting drug was suspended and systemic corticoid treatment was initiated (prednisolone 0.5 mg/kg/day). Symptoms relapsed under corticoid tapering with greater severity. The patient developed an exuberant rash associated with peripheral lymphadenopathies, marked eosinophilia and hepatic cytolysis. The diagnosis of DRESS syndrome to lamotrigine was made. Prednisolone dosage was increased to 1 mg/kg/day, and the subsequent taper was performed slowly over the course of 10 weeks. Full clinical remission was observed.

scholarly journals Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome induced by ceftriaxone with successful treatment — A case report and literature review

2022 ◽  
Vol 8 (4) ◽  
pp. 298-300
Author(s):  
Arpit Agrawal ◽  
Pankaj Kannauje
Keyword(s):  
Drug Reaction ◽  
Case Report ◽  
Literature Review ◽  
Sore Throat ◽  
Hypersensitivity Reactions ◽  
Dress Syndrome ◽  
Threatening Condition ◽  
Life Threatening ◽  
Systemic Symptoms ◽  
Prolonged Latency

Drug reaction with eosinophilia and systemic symptoms is a rare and potentially life threatening condition characterised by hypersensitivity reactions to a drug with prolonged latency, in the form of skin rashes, hyper eosinophilia and systemic features like fever, lymphadenopathy, leucocytosis, internal organ involvement (liver, kidney, lung). Though it can occur in response to many drugs but very few cases has been described in relation to one of the most commonly used antibiotic ceftriaxone. Here we have described a case of DRESS in a patient who has been treated with ceftriaxone outside our hospital for sore throat.

scholarly journals Hepatic manifestations of drug reaction with eosinophilia and systemic symptoms syndrome

2021 ◽  
Author(s):  
Maria Gabriela Delgado ◽  
Stefania Casu ◽  
Matteo Montani ◽  
Felix Brunner ◽  
Nasser Semmo ◽  
...  
Keyword(s):  
Drug Reaction ◽  
Liver Failure ◽  
Acute Liver Failure ◽  
Acute Hepatitis ◽  
Clinical Presentation ◽  
Dress Syndrome ◽  
Multiple Organs ◽  
Life Threatening ◽  
Systemic Symptoms

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a potentially life-threatening drug reaction, which can affect multiple organs. Patients with DRESS syndrome and hepatic manifestations may present alterations ranging from mild hepatitis to acute liver failure. The diagnosis might be difficult, and the management of these patients is challenging. This report analyzes a series of five cases reporting the clinical presentation, which ranged from acute hepatitis to liver failure, and discussed their treatment.

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