Southern African Journal of HIV Medicine (Dec 2018)

A case of a drug reaction to sulfasalazine in a patient infected with HIV

  • Leanne Swart,
  • Elise Schapkaitz,
  • Anima Baiden

DOI
https://doi.org/10.4102/sajhivmed.v19i1.829
Journal volume & issue
Vol. 19, no. 1
pp. e1 – e3

Abstract

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Introduction: The diagnosis of drug reaction with eosinophilia and systemic symptoms (DRESS) in human immunodeficiency virus (HIV) patients on multiple drugs with concomitant disorders presents a diagnostic challenge. Patient presentation: We describe a case of a drug reaction to sulfasalazine in a 46 year old HIV-infected female with concurrent rheumatoid arthritis which presented atypically with a marked peripheral blood plasmacytosis mimicking a lymphoproliferative neoplasm. Management and outcome: A diagnosis of DRESS was made in conjunction with the laboratory and clinical presenting findings. Sulfasalazine was immediately discontinued. The mucocutaneous rash and systemic symptoms (which included fever, lymphadenopathy and multi-organ dysfunction) resolved with supportive treatment. This included topical and systemic corticosteroids. Conclusion: In conclusion, it is important to consider drug reactions when evaluating patients infected with HIV.

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