scholarly journals Dapsone-induced drug reaction with eosinophilia and systemic symptoms (DRESS): the role of the primary care physician

2021 ◽  
Vol 55 (2) ◽  
pp. 169-172
Author(s):  
Blessing O Akor ◽  
Bob Ukuonu ◽  
Alexander A. Akor ◽  
Ojonugua A Ameh ◽  
Theresa Otu ◽  
...  
Keyword(s):  
Drug Reaction ◽  
Health Centre ◽  
Final Diagnosis ◽  
Care Physician ◽  
Coordination Of Care ◽  
High Grade Fever ◽  
Systemic Symptoms ◽  
Generalized Lymphadenopathy ◽  
High Index Of Suspicion

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare but severe adverse drug reaction with debilitating morbidity and high mortality. The interest of this presentation is to report a case of dress and the role of the healthcare coordinator (family physician) in early diagnosis, prompt treatment and coordination of care. We report a case of a 32-year-old male who was wrongly commenced on Dapsone for seizure disorder from a primary health centre. He presented two months later with a month history of severe dry cough, pleurisy, intermittent breathlessness and high-grade fever. He had a generalized pruritic rash with erythema and desquamation. There was marked oedema of the face and feet with generalized lymphadenopathy. He was jaundiced with tender hepatomegaly. He had dark coloured urine and a trace of proteinuria but normal renal function. There was marked leukocytosis (35*109/l) with eosinophilia (36%). His chest X-ray and viral screen for HBV, HCV and HIV were all negative. The multiple systemic presentations warranted a multidisciplinary review, and a final diagnosis of DRESS was made. His symptoms began to resolve within two days of withdrawal of the offending drug and commencement of oral corticosteroid with supportive care for his symptoms. At six weeks, there was a complete resolution of clinical features, and his laboratory parameters had returned to the baseline. Diagnosis of DRESS can be challenging, and a high index of suspicion is required. The multidisciplinary coordination of care by the first line physicians can also not be overemphasized for good outcomes.

Rate of drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome with raltegravir and role of the HLA-B*53

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
M Lefebvre ◽  
A Walencik ◽  
C Allavena ◽  
E Billaud ◽  
A Kassi ◽  
...  
Keyword(s):  
Drug Reaction ◽  
Dress Syndrome ◽  
Systemic Symptoms

scholarly journals Communication between health professionals and their influence on the coordination of care

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M F M Mendes ◽  
I C Samico ◽  
Z M A Hartz
Keyword(s):  
Primary Care ◽  
Primary Care Physician ◽  
Primary Care Physicians ◽  
Diagnostic Errors ◽  
Care Physician ◽  
Primary Role ◽  
Coordination Of Care ◽  
Levels Of Care ◽  
Specialized Care

Abstract Background Problems linked to the coordination of care may represent a lack of communication between levels of care and reflect diagnostic errors, duplication of tests and unnecessary hospitalizations. This study aims to understand the role of communicational relationships between professionals and their influence on coordination between levels of care. Methods An evaluative and qualitative nature research. 24 interviews were carried out, with primary care physicians and specialists, institutional supporters and managers of a public health network in Pernambuco, Brazil. The content thematic analysis worked out sought to identify synergies and contradictions in the relationships between the actors. Results Knowledge about the role of primary care was incomplete, not being understood its primary role as a care provider. The primary care physician was not recognized as the responsible physician by most professionals. The specialists considered the references poorly filled out and showed a lack of confidence in the primary care physician, who in turn revealed that he did not receive any counter-reference and difficulty in contacting a specialist. Few articulation mechanisms have been reported between levels and the use of informal communication mechanisms. The managers acknowledged the existence of problems, but highlighted the commitment of management in the actions for organizing the network. The “goodwill” of the professionals was considered an articulation facilitator, but not a sufficient practice. Conclusions The results allowed to deepen the look at the complexity of the relationships between the actors and how they can influence coordination. Since is perceived the communicational tensions and weaknesses, it is urgent to think of strategies that establish institutionalized spaces for meetings and dialogues that allow articulation among professionals. Key messages The study analyzes communicational relationships between primary and specialized care professionals and their influence on the coordination of care. Strategies for mutual collaboration are mandatory.

scholarly journals Drug Reaction with Eosinophilia and Systemic Symptoms: A Complex Interplay between Drug, T Cells, and Herpesviridae

2021 ◽  
Vol 22 (3) ◽  
pp. 1127
Author(s):  
Luckshman Ganeshanandan ◽  
Michaela Lucas
Keyword(s):  
Drug Reaction ◽  
Human Leukocyte ◽  
Molecular Techniques ◽  
Dress Syndrome ◽  
Complex Interplay ◽  
Drug Induced ◽  
Leukocyte Antigen ◽  
Systemic Symptoms ◽  
Delayed Hypersensitivity Reaction

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, also known as drug induced hypersensitivity (DiHS) syndrome is a severe delayed hypersensitivity reaction with potentially fatal consequences. Whilst recognised as T cell-mediated, our understanding of the immunopathogenesis of this syndrome remains incomplete. Here, we discuss models of DRESS, including the role of human leukocyte antigen (HLA) and how observations derived from new molecular techniques adopted in key studies have informed our mechanism-based understanding of the central role of Herpesviridae reactivation and heterologous immunity in these disorders.

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 Management of carbamazepine induced drug reaction with eosinophlia and systemic symptoms in Mediheal hospital-Nakuru, Kenya: a case report

2018 ◽  
Vol 4 (4) ◽  
pp. 600
Author(s):  
Ramadhan L. Mawenzi ◽  
Dhiren Parikh
Keyword(s):  
Drug Reaction ◽  
Early Recognition ◽  
Oral Prednisone ◽  
Cervical Lymphadenopathy ◽  
Maculopapular Rash ◽  
Topical Steroids ◽  
Positive Serology ◽  
Systemic Corticosteroids ◽  
Systemic Symptoms ◽  
High Index Of Suspicion

<p class="abstract">Adverse drug reactions (ADR) are undesirable events occurring as consequences of an ingested, injected or applied drug. Their spectrum can range from mild to severe reactions. Severe Cutaneous Adverse Reactions (SCARs) are diverse in presentation and in consequence. Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a type of life-threatening SCAR which affects the skin as well as the internal organs. Various drugs can cause DRESS, but aromatic anticonvulsants, especially carbamazepine are considered the major culprits. The diagnosis of DRESS requires a high index of suspicion followed by an intense sign-searching clinical examination guided by established criteria. We report a previously healthy 53 year old man of Kenyan ancestry who developed fever, widespread maculopapular rash, swollen eyelids and cervical lymphadenopathy three weeks after carbamazepine. Liver enzymes were markedly elevated and he had lymphocytopenia and a positive serology for human herpes virus type 6 (HHV6). Using the RegiSCAR criteria a probable diagnosis of DRESS secondary to carbamazepine was made. His treatment involved discontinuation of the drug, intravenous hydrocortisone together with mild topical steroids. He remarkably improved and was discharged on oral prednisone and followed up for three consecutive months. The length of his hospitalisation was ten days. Carbamazepine has potential to provoke DRESS in patients of Kenyan ancestry. DRESS should be anticipated before and during use of carbamazepine for early recognition. Treatment of DRESS should involve the immediate withdrawal of offending drug and rapid initiation of systemic corticosteroids as well as application of diluted topical steroids to sooth the skin.</p>

scholarly journals Phenytoin Induced Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)

2015 ◽  
Vol 35 (1) ◽  
pp. 73-75 ◽  
Author(s):  
NK Natt ◽  
S Tarsem ◽  
Dr Anuba ◽  
S Simarjeet ◽  
M Sharma ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Drug Reaction ◽  
Skin Rash ◽  
Drug Effect ◽  
Rapid Diagnosis ◽  
Age Group ◽  
Life Saving ◽  
Paediatric Age ◽  
Systemic Symptoms ◽  
High Index Of Suspicion

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare and potentially fatal adverse effect characterized by a skin rash with visceral involvement and haematological abnormalities. This adverse drug effect is often misdiagnosed and under-reported especially in paediatric age group due to its rarity and high occurrence of skin rash in various other viral illnesses of children. We report a case of DRESS in a three months old male child. A high index of suspicion, rapid diagnosis and prompt withdrawal can be life-saving for the patient.J Nepal Paediatr Soc 2015;35(1):73-75

scholarly journals A probable case of sodium valproate monotherapy induced drug reaction with eosinophilia and systemic symptoms syndrome: a case report in Indian population

2020 ◽  
Vol 9 (6) ◽  
pp. 991
Author(s):  
Vijayamathy Arunnair ◽  
Girish Kumaraswamy ◽  
Ramesh M.
Keyword(s):  
Drug Reaction ◽  
Bipolar Disorders ◽  
Maculopapular Rash ◽  
Hypersensitivity Syndrome ◽  
Dress Syndrome ◽  
Drug Induced ◽  
Probable Case ◽  
History Of ◽  
Systemic Symptoms ◽  
Generalized Lymphadenopathy

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a drug-induced hypersensitivity syndrome most commonly caused by anti-epileptics like carbamazepine, phenytoin. It usually manifests as maculopapular rash, fever, eosinophilia, generalized lymphadenopathy, hepatitis, atypical lymphocytosis, and leucocytosis with the involvement of other organs. Valproate, a broad-spectrum antiepileptic, also used in bipolar disorders and migraine prophylaxis, is generally well tolerated. To date, very few cases of valproate monotherapy induced DRESS syndrome have been reported worldwide and here we are reporting one such rare case in a 72 years old Indian woman with a history of generalised tonic convulsions. The patient was classified as a ‘probable’ case of DRESS syndrome using the WHO-UMC criteria and Naranjo scale. Discontinuation of the offending medication and treatment with intravenous (IV) fluids, antihistamines, and steroids helped in recovery of the patient. Healthcare practitioners must be aware of valproate monotherapy induced DRESS syndrome and take effective measures to avoid severe side effects. 

Sulfasalazine-induced drug reaction with eosinophilia and systemic symptoms (DRESS) with concomitant acute chikungunya virus infection: possible role of new viral trigger

2021 ◽  
Vol 14 (10) ◽  
pp. e244063
Author(s):  
Abheek Sil ◽  
Moni Sankar Bhattacharjee ◽  
Atanu Chandra ◽  
Jayasri Das Pramanik
Keyword(s):  
Drug Reaction ◽  
Virus Infection ◽  
Renal Dysfunction ◽  
Skin Rash ◽  
Chikungunya Virus ◽  
Drug Effect ◽  
Signs And Symptoms ◽  
Viral Aetiology ◽  
Systemic Symptoms

Drug reaction with eosinophilia and systemic symptoms (DRESS) is designated as a potentially lethal adverse drug effect with characteristic signs and symptoms such as skin rash, fever, leucocytosis with eosinophilia or atypical lymphocytes, lymphadenopathy and liver or renal dysfunction. In addition to most commonly implicated drug category (aromatic anticonvulsants), lamotrigine, sulfonamides, dapsone and abacavir may also induce this syndrome. We describe here a case a sulfasalazine-induced DRESS with coexisting chikungunya fever. The shared presentation of fever with rash in both conditions made it a challenging diagnosis. Sulfasalazine hypersensitivity manifesting as DRESS has rarely been reported. Furthermore, we document chikungunya virus (CV) as a possible triggering agent for DRESS. To the best of our knowledge, CV as a viral aetiology in DRESS has not been reported previously in the literature.

GERMAS ( Gerakan Masyarakat Hidup Sehat) Di Desa Rambah Hilir

2020 ◽  
Vol 3 (1) ◽  
pp. 100
Author(s):  
Elvira Junita ◽  
Yuli Handayani ◽  
Lufita Nur Alfiah
Keyword(s):  
Fruits And Vegetables ◽  
Healthy Lifestyle ◽  
Health Centre ◽  
Health Check ◽  
Community Partnership ◽  
Health It ◽  
Community Members ◽  
Healthy Life ◽  
Partnership Program

AbstrakPermasalahan kesehatan yang timbul saat ini merupakan akibat dari perilaku hidup yang tidak sehat. Gaya hidup yang kurang baik mengakibatkan tingginya angka kejadian Penyakit Tidak Menular, Di Desa Rambah Hilir kunjungan penderita hipertensi dan diabetes di Puskesmas Rambah Hilir I di tahun 2018 ini sampai bulan Juni 66 kasus Hipertensi 27 Kasus Diabetes. Gerakan Masyarakat Hidup Sehat (GERMAS) merupakan progam Pemerintah untuk mengajak masyarakat hidup sehat dengan focus pada 3 kegiatan utama yaitu melakukan aktifitas fisik, makan buah sayur dan cek kesehatan secara rutin minimal enam bulan sekali.Dalam Program Kemitraan Masyarakat ini upaya yang dilakukan adalah meningkatkan gaya hidup sehat yakni meningkatnya aktifitas fisik yang dilakukan dengan melaksanakan kegiatan rutin senam bersama setiap hari minggu dan meningkatkan konsumsi buah dan sayur dengan memanfaatkan lahan perkarangan rumah warga dengan menanam buah dan sayur dihalaman rumah untuk memenuhi kebutuhan konsumsi buah dan sayur. Upaya Peningkatan peran masyarakat dalam memeriksakan kesehatannya dengan mendirikan posko kesehatan untuk memudahkan masyarakat dalam memeriksa kesehatannya. Luaran yang telah dicapai adalah Adanya kegiatan senam rutin, meningkatnya konsumsi buah dan sayur dengan Adanya tanaman buah dan sayur disetiap rumah warga, makan buah dan sayur bersama setiap hari minggu, Adanya pemeriksaan kesehatan secara berkala.Abstract.Health problems that currently emergeare resulted from unhealthy living behaviours. A bad lifestyle causes an increase innon-communicable diseases cases. According to patient visit data until June 2018 at the community health centre (Puskesmas) Rambah Hilir I, Rambah Hilir Village, Rokan Hulu, Riau, it shows that there were 66 cases of hypertension and 27 cases of diabetes.The Healthy Life Society Movement (GERMAS) is a government program to encourage people to live a healthy lifestyle focusing on 3 main activities namely physical activities, eating vegetables, together with regular health check-upsat least once every 6 months. This community partnership program attempts to enhance the healthy lifestyle by intensifying physical activitiesthrough a routine collective exercise on every Sunday and increasing fruits and vegetables consumption. The community members’ yards are used as land to grow fruits and vegetables for meeting the community’s needs. Regarding the effort to improve the role of the community members to check their health, it was carried out by establishing a health post to facilitate them in checking-up their health. Outputs that have been achieved are the routine exercise; an increase in fruits and vegetables consumptionasthere are fruit and vegetable plants in every resident's houses; eating fruits and vegetables collectively on every Sunday; as well as regular health check-ups.

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