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Allergy, Asthma & Clinical Immunology
Published in: Allergy, Asthma & Clinical Immunology 1/2011

Open Access 01-12-2011 | Case report

DRESS with delayed onset acute interstitial nephritis and profound refractory eosinophilia secondary to Vancomycin

Authors: Paloma O'Meara, Rozita Borici-Mazi, A Ross Morton, Anne K Ellis

Published in: Allergy, Asthma & Clinical Immunology | Issue 1/2011

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Abstract

Background

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a relatively rare clinical entity; even more so in response to vancomycin.

Methods

Case report.

Results

We present a severe case of vancomycin-induced DRESS syndrome, which on presentation included only skin, hematological and mild liver involvement. The patient further developed severe acute interstitial nephritis, eosinophilic pneumonitis, central nervous system (CNS) involvement and worsening hematological abnormalities despite immediate discontinuation of vancomycin and parenteral corticosteroids. High-dose corticosteroids for a prolonged period were necessary and tapering of steroids a challenge due to rebound-eosinophilia and skin involvement.

Conclusion

Patients with DRESS who are relatively resistant to corticosteroids with delayed onset of certain organ involvement should be treated with a more prolonged corticosteroid tapering schedule. Vancomycin is increasingly being recognized as a culprit agent in this syndrome.
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Metadata
Title
DRESS with delayed onset acute interstitial nephritis and profound refractory eosinophilia secondary to Vancomycin
Authors
Paloma O'Meara
Rozita Borici-Mazi
A Ross Morton
Anne K Ellis
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Allergy, Asthma & Clinical Immunology / Issue 1/2011
Electronic ISSN: 1710-1492
DOI
https://doi.org/10.1186/1710-1492-7-16

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