A fatal case of drug reaction with eosinophilia and systemic symptom syndrome associated with cytomegalovirus reactivation

Abstract

Drug reaction with eosinophilia and systemic symptom (DRESS) syndrome is a severe adverse drug-induced reaction. Diagnosing DRESS syndrome is also challenging due to the diversity of cutaneous eruption and the organs involved. Here, we described an 88-year-old Chinese woman who developed DRESS syndrome under combined therapy of nonsteroidal anti-inflammatory drugs (NSAIDs) and chlormezanone (CM) accompanied with cytomegalovirus reactivation. DRESS syndrome should be highly suspected in patients with symptoms, including skin rash, fever, liver involvement, hypereosinophilia, and lymphadenopathy, especially coexisted with reactivation of the cytomegalovirus. Early withdrawal of the culprit drug is necessary once the diagnosis is established.

Keywords

• Acute pancreatitis
• chlormezanone
• drug reaction with eosinophilia and systemic symptom syndrome
• drug reaction
• eosinophilia
• liver decompensation
• multiple organ failure
• nonsteroidal anti-inflammatory drug