scholarly journals Delayed aminopenicillin reaction associated to human herpes virus 6 infection mimicking DRESS syndrome

2019 ◽  
Vol 66 (3) ◽  
pp. 375 ◽  
Author(s):  
Laura Míguez-Martín ◽  
Helena Higelmo-Gómez ◽  
Ángela Gómez-Farpón ◽  
Francisco Álvarez-Caro
Keyword(s):  
Human Herpesvirus ◽  
Dress Syndrome ◽  
Drug Induced ◽  
Delayed Reaction ◽  
Malar Rash ◽  
Human Herpes Virus ◽  
Human Herpes Virus 6 ◽  
Delayed Reactions ◽  
Systemic Symptoms ◽  
High Index Of Suspicion

Background: DRESS syndrome (rash with eosinophilia and systemic symptoms) is an uncommon and severe drug-induced reaction.Case report: An 8-year-old boy was diagnosed with tonsillopharyngitis, and treatment with amoxicillin was started. One day later, he presented bilateral malar rash which evolved to generalized erythroderma in two days. He was referred to the emergency room and then he was discharged after the treatment with amoxicillin was discontinued. Five days later, he still had fever, progressive facial and acral edema, and ecchymotic lesions. The laboratory studies showed 6220 leukocytes/mm3 (970 eosinophils/mm3). The pharyngeal culture tested positive to human herpesvirus 6 (HHV-6). The fever, rash and edema disappeared with supportive measures. Based on the results of the allergy tests, a diagnosis of delayed reaction to aminopenicillin associated to HHV-6 mimicking DRESS syndrome was made, with the recommendation to avoid penicillin antibiotics.Conclusions: The diagnosis of delayed reactions to aminopenicillin and DRESS syndrome requires a high index of suspicion in order to promptly withdraw the offending medication and to avoid delays in the diagnosis.

Drug-Induced Hypersensitivity Syndrome due to Mexiletine Associated with Human Herpes Virus 6 and Cytomegalovirus Reactivation

2005 ◽  
Vol 32 (4) ◽  
pp. 278-281 ◽  
Author(s):  
Atsushi Sekiguchi ◽  
Takayuki Kashiwagi ◽  
Akemi Ishida-Yamamoto ◽  
Hidetoshi Takahashi ◽  
Yoshio Hashimoto ◽  
...  
Keyword(s):  
Herpes Virus ◽  
Hypersensitivity Syndrome ◽  
Human Herpes ◽  
Drug Induced ◽  
Cytomegalovirus Reactivation ◽  
Human Herpes Virus ◽  
Human Herpes Virus 6 ◽  
Herpès Virus

scholarly journals Dress Syndrome - A Case Report

2016 ◽  
Vol 8 (2) ◽  
pp. 95-100 ◽  
Author(s):  
Zorana Kremić ◽  
Željko P. Mijušković ◽  
Lidija Kandolf-Sekulović
Keyword(s):  
Supportive Therapy ◽  
Dress Syndrome ◽  
Drug Induced ◽  
Systemic Manifestations ◽  
Inflammatory Drugs ◽  
Hematological Abnormalities ◽  
Systemic Symptoms ◽  
Generalized Epilepsy ◽  
Maculopapular Exanthema ◽  
Induced Reaction

Abstract The drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is an adverse drug-induced reaction that occurs most commonly after exposure to drugs, most frequently anticonvulsants, sulfa derivates, antidepressants, nonsteroidal anti-inflammatory drugs, and antimicrobials. We present a 61-year-old male, with a generalized maculopapular exanthema on the trunk, face, extremities, palms, soles, palate, and fever (38°C). His medical history was notable for generalized epilepsy, treated with carbamazepine during 1 month. The diagnosis of DRESS syndrome was confirmed by specific RegiSCAR criteria. In our case, skin eruptions were successfully treated with oral methylprednisolone, cephalexin, and topical corticosteroid ointment. In conclusion, although the mechanisms of this syndrome are not completely understood, numerous cases were reported in children and adults. This syndrome should be considered in every patient with skin eruption, fever, eosinophilia, liver and hematological abnormalities. Prompt recognition, supportive therapy and initiation of corticosteroids may prevent systemic manifestations.

scholarly journals Case Reports of DRESS Syndrome and Symptoms Consistent with DRESS Syndrome Following Treatment with Recently Marketed Monoclonal Antibodies

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
James C. Di Palma-Grisi ◽  
Kesav Vijayagopal ◽  
Muhammad A. Muslimani
Keyword(s):  
Monoclonal Antibodies ◽  
Case Reports ◽  
Maculopapular Rash ◽  
Phase Iii ◽  
Dress Syndrome ◽  
Drug Induced ◽  
Diagnostic Reliability ◽  
Phase Iii Clinical Trials ◽  
Life Threatening ◽  
Systemic Symptoms

Background. Monoclonal antibodies constitute a potent and broadly tolerable drug class, representing for some conditions the first newly approved treatment in years. As such, many are afforded “fast-track” or “breakthrough therapy” designations by the U.S. Food and Drug Administration, leading to provisional approval before Phase III clinical trials are reported. Although these drugs are usually safe, some patients experience life-threatening complications—myositis and encephalitis have led to permanent or temporary recalls. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a hypersensitivity condition easily missed due to its long incubation period and nonspecific presentation. This minireview is primarily intended as an abbreviated guide for practitioners who may be using these powerful treatments. Methodology. We searched PubMed using a string of symptoms consistent with DRESS syndrome and monoclonal antibodies approved by the FDA since 2015. Then, we excluded studies reporting dermatological complications of reactivation of nonherpetic infection, immunodeficiency-related infection, or reactions to the injection site or infusion. We searched for and accessed prior reviews and background studies via PubMed, Mendeley, and Google Scholar. Results. Two cases of DRESS syndrome were identified in the literature, both the result of treatment with daclizumab. There was one additional case of encephalitis without cutaneous symptoms caused by daclizumab. Drug-induced hypersensitivity dermatitis was reported following treatment with nivolumab and two cases of combination treatment with ipilimumab and either nivolumab or durvalumab produced maculopapular rash and bullae in the first patient and lichenoid dermatitis and blisters in the second patient. Conclusions. Daclizumab was the only recently approved monoclonal antibody associated with DRESS syndrome as such. Limitations in the diagnostic reliability of DRESS syndrome as a clinical entity and the lack of negative clinical trial reporting suggest enhanced vigilance on the part of clinicians and regulators may be warranted.

scholarly journals Successful Treatment of Antiepileptic Drug-Induced DRESS Syndrome with Pulse Methylprednisolone

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Celebi Kocaoglu ◽  
Ceyda Cilasun ◽  
Ece Selma Solak ◽  
Gulcan S. Kurtipek ◽  
Sukru Arslan
Keyword(s):  
Valproic Acid ◽  
Present Report ◽  
Treatment Modalities ◽  
Dress Syndrome ◽  
Internal Organs ◽  
Drug Induced ◽  
Pulse Methylprednisolone ◽  
Lymph Node Enlargement ◽  
Life Threatening ◽  
Systemic Symptoms

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare but potentially life-threatening syndrome characterized by skin rash, fever, lymph node enlargement, and involvement of internal organs. It is most commonly induced by aromatic anticonvulsants and antibiotics. Nonaromatic anticonvulsants are rarely encountered as the causes of DRESS syndrome. In the present report, three discrete cases with DRESS syndrome developing due to three antiepileptic drugs, including valproic acid (nonaromatic), carbamazepine (aromatic), and lamotrigine (aromatic), and their treatment modalities were aimed to be discussed in light of the literature. To the best of our knowledge, our cases are the first children to be treated with pulse methylprednisolone in the literature.

scholarly journals Drug-induced Hypersensitivity Syndrome Following Meningoencephalitis Associated with Human Herpes Virus-6

2013 ◽  
Vol 102 (10) ◽  
pp. 2682-2684 ◽  
Author(s):  
Natsu Suematsu ◽  
Sachiko Nakamura ◽  
Naoto Takahashi ◽  
Yasuhisa Hino ◽  
Mariko Takata ◽  
...  
Keyword(s):  
Herpes Virus ◽  
Hypersensitivity Syndrome ◽  
Human Herpes ◽  
Drug Induced ◽  
Human Herpes Virus ◽  
Human Herpes Virus 6 ◽  
Herpès Virus
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