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

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.

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Lamotrigine induced DRESS syndrome in a child: a case report and literature review

10.21203/rs.3.rs-151612/v1 ◽

2021 ◽

Author(s):

Chien-Heng Lin ◽

Sheng-Shing Lin ◽

Syuan-Yu Hong ◽

Chieh-Ho Chen ◽

I-Ching Chou

Keyword(s):

Drug Reaction ◽

Case Report ◽

Literature Review ◽

Skin Rash ◽

Anticonvulsant Drug ◽

Dress Syndrome ◽

Life Threatening ◽

History Of ◽

History Of Epilepsy ◽

Systemic Symptoms

Abstract BackgroundLamotrigine is an important anticonvulsant drug. Its use, however, has been limited by the risk of potentially life-threatening dermatological reactions, such as drug reaction with eosinophilia and systemic symptoms (DRESS).Case presentationHere, 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 stable condition.ConclusionAnticonvulsant drugs such as lamotrigine 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.

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Drug reaction with eosinophilia and systemic symptoms (DRESS syndrome)

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.62.03.227 ◽

2016 ◽

Vol 62 (3) ◽

pp. 227-230 ◽

Cited By ~ 4

Author(s):

Soraia Aparecida da Silva ◽

Mariana Maciel Pereira de Figueiredo ◽

Lauro Carneiro Neto ◽

Débora Borowiak Reiss ◽

Mariana Amaranto de Souza Damásio

Keyword(s):

Drug Reaction ◽

Case Report ◽

Literature Review ◽

Hypersensitivity Reaction ◽

Laboratory Tests ◽

Immune Status ◽

Target Organ ◽

Dress Syndrome ◽

Risk Of Mortality ◽

Systemic Symptoms

SUMMARY Objective: To review the hypersensitivity reaction to drugs known as drug reaction with eosinophilia and systemic symptoms (DRESS syndrome), based on a case report. We also intend to discuss the difficulty and importance of disease recognition, since none of the changes is pathognomonic of this disease and failure to identify it may have disastrous consequences for the patient. Method: To describe this case report, in addition to the information collected for clinical assessment, a literature review was performed in the PubMed and Bireme databases in order to retrieve the latest information published in literature on DRESS syndrome. Results: The case of a 20-year old patient is reported. After anamnesis, physical examination and laboratory tests a diagnosis of DRESS syndrome was performed, characterized by rash, hematologic alterations, lymphadenopathy and lesions in target organ. This is a rare syndrome, whose frequency varies according to the drug used and the immune status of the patient, being more often associated with the use of anticonvulsants. Conclusion: The approach and discussion of the topic are of paramount importance, in view of the potential lethality of this treatable syndrome. Recognizing the occurrence of DRESS syndrome and starting treatment as soon as possible is crucial to reduce the risk of mortality and improve prognosis.

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Drug reaction with eosinophilia and systemic symptoms associated with carbamazepine (DRESS syndrome) – case report and literature review

Dermatology Review ◽

10.5114/dr.2016.62890 ◽

2016 ◽

Vol 5 ◽

pp. 376-382

Author(s):

Kamila Ociepa ◽

Anna Woźniacka ◽

Agnieszka Żebrowska

Keyword(s):

Drug Reaction ◽

Case Report ◽

Literature Review ◽

Dress Syndrome ◽

Systemic Symptoms

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

Children ◽

10.3390/children8111063 ◽

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.

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

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20191610 ◽

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.

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Relapse of Sulfasalazine-induced DRESS Syndrome Following the Administration of Contrast Media: A Case Report

Case Reports in Clinical Practice ◽

10.18502/crcp.v6i3.7121 ◽

2021 ◽

Author(s):

Niayesh Mohebbi ◽

Hamidreza Taghvaye Masoumi ◽

Malihe Khosravi Khezri ◽

Mona Talaschian

Keyword(s):

Drug Reaction ◽

Case Report ◽

Contrast Media ◽

Acute Exacerbation ◽

Hypersensitivity Reactions ◽

Iodinated Contrast Media ◽

Dress Syndrome ◽

Iodinated Contrast ◽

Systemic Symptoms ◽

High Possibility

Sulfasalazine, a non-antibiotic sulfonamide, is associated with severe hypersensitivity reactions, including Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome. We report a case of sulfasalazine-induced DRESS syndrome that relapsed following the administration of visipaque® (iodixanol). Macular rashes, pruritus, and an acute exacerbation of dyspnea were immediately observed after the administration of contrast media. It seems that patients suffering from DRESS syndrome are sensitive to the administration of other new medications with a high possibility of hypersensitive reactions. It can be concluded that iodinated contrast media should be used cautiously in patients with DRESS syndrome.

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EBV Reactivation in A Case of DRESS Syndrome Associated with Lamotrigine – A Case Report

New Emirates Medical Journal ◽

10.2174/03666211230091347 ◽

2021 ◽

Vol 03 ◽

Author(s):

Mahmoud Ahmed Kiblawi ◽

Mohamad El Saleh ◽

Ashraf El Ghul

Keyword(s):

Drug Reaction ◽

Hypersensitivity Reaction ◽

Topical Steroids ◽

Dress Syndrome ◽

Case Presentation ◽

Ebv Reactivation ◽

Culprit Drug ◽

Threatening Condition ◽

Life Threatening ◽

Systemic Symptoms

Background: Drug reaction with eosinophilia and systemic symptoms (DRESS syndrome) is a rare, T-cell mediated hypersensitivity reaction that develops secondary to a drug reaction. Several drugs have been associated with DRESS syndrome, most commonly carbamazepine. The mechanism is not clearly understood. It is a life-threatening condition that can present with skin rash, hematologic abnormalities, lymphadenopathy, and organ failure. Case Presentation: The authors report a case of 43-year-old gentleman who developed DRESS syndrome secondary to lamotrigine and was found to have EBV reactivation. Patient was managed with supportive care; topical steroids and the culprit drug were discontinued. He had full recovery almost 2 weeks following treatment. DRESS syndrome can occur 2 weeks following exposure to an offending drug in susceptible individuals. Conclusion: Lamotrigine and EBV reactivation are not frequently reported in patients with DRESS syndrome. Therefore, physicians should be vigilant about this rare drug related hypersensitivity reaction in order to prevent life threatening complications.

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Case Report: Alpelisib-Induced Drug Reaction With Eosinophilia and Systemic Symptoms: A Rare Manifestation of a Common Side Effect

Frontiers in Oncology ◽

10.3389/fonc.2021.726785 ◽

2021 ◽

Vol 11 ◽

Author(s):

Umair Majeed ◽

Tudor Puiu ◽

Jason Sluzevich ◽

Gina Reynolds ◽

Marites Acampora ◽

...

Keyword(s):

Drug Reaction ◽

Case Report ◽

Side Effect ◽

Common Side Effect ◽

Dress Syndrome ◽

Initial Exposure ◽

First Case ◽

Rare Manifestation ◽

Life Threatening ◽

Systemic Symptoms

Alpelisib is a PIK3a inhibitor approved for the treatment of metastatic ER+ breast cancer in combination with fulvestrant. Although rash is a common side effect of this medication, we present the first case of drug reaction with eosinophilia and systemic symptoms (DRESS) upon initial exposure to alpelisib. Here we describe the clinical-pathological findings and management of our patient with alpelisib-induced life-threatening DRESS syndrome. The goal of this case report is to highlight association of alpelisib with DRESS syndrome, in clinical practice, so that alpelisib can be immediately stopped and treatment for this serious condition promptly initiated.

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Cardiac tamponade as a late complication of a minor trauma due to syncope: A case report and literature review

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907918793790 ◽

2018 ◽

Vol 27 (2) ◽

pp. 103-106 ◽

Cited By ~ 1

Author(s):

Matteo Guarino ◽

Alessandra Bologna ◽

Alfredo De Giorgi ◽

Michele D Spampinato ◽

Christian Molino ◽

...

Keyword(s):

Case Report ◽

Literature Review ◽

Cardiac Tamponade ◽

Blunt Chest Trauma ◽

Chest Trauma ◽

Late Complication ◽

Minor Trauma ◽

Threatening Condition ◽

Life Threatening ◽

A Minor

Haemopericardium with cardiac tamponade following minor blunt trauma is a rare, life-threatening condition. The diagnosis of cardiac tamponade as well as therapeutic management may be delayed, since the link between trauma and illness is often overlooked. We report the case of an old woman who developed a relatively delayed cardiac tamponade due to an otherwise minor blunt chest trauma following syncope.

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