The case of the magenta woman (DRESS syndrome). Issue 1 (2nd January 2020)

• Record Type: Journal Article
• Authors: Swali, Ritu; Ghazarian, Armen
• Is Part Of: Proceedings. Volume 33:Issue 1(2020)
• Page Start: 115
• Page End: 116
• Publication Date: 2020-01-02
• Subjects: Antibiotics -- dermatology -- dermatopathology -- drug rash -- vancomycin; Medicine -- Periodicals; Medicine; Medicine -- Periodicals; Periodicals; Electronic journals; 616.005
• DOI: 10.1080/08998280.2019.1686926
• Languages: English
• ISSNs: 0899-8280

Abstract

Abstract: Drug reaction with eosinophilia and systemic symptoms, otherwise known as DRESS syndrome, is a rare, potentially life-threatening drug-induced hypersensitivity reaction that primarily involves a widespread skin rash, fever, hematological abnormalities, lymphadenopathy, and organ injury. Anti-epileptics, sulfonamides, and allopurinol are the most common triggers, but other offending medications have been reported in the literature. Vancomycin has been increasingly reported over the past 5 years, with 26 cases reported to date. Here we describe a case of a 44-year-old woman who presented with a cutaneous drug reaction with single-organ damage to the kidneys, likely triggered by 1 month treatment of osteomyelitis with intravenous vancomycin. The patient's clinical picture was initially consistent with recurring red-man syndrome that eventually became persistent after failing treatment with infusion rate reduction and diphenhydramine. This case highlights the need for a detailed review of medications taken within 2 months of the onset of the rash, as well as the importance of being cognizant of medications that incite multiple drug reactions.