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BMC Pulmonary Medicine

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Open Access 01-12-2017 | Case report

Case report: atypical presentation of vancomycin induced DRESS syndrome: a case report and review of the literature

Authors: Olivia Wilcox, Mohamed Hassanein, John Armstrong, Nader Kassis

Published in: BMC Pulmonary Medicine | Issue 1/2017

Abstract

Background

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe hypersensitivity drug reaction involving the skin and multiple internal organ systems. The symptoms typically present with fever and skin rash, and rapidly progress to multiple organ failures. Vancomycin is a rare drug to cause DRESS syndrome with 23 cases reported to date.

Case presentation

We described a case of a 39 year-old man who was treated with vancomycin for osteomyelitis of the foot. The patient subsequently developed acute respiratory distress syndrome (ARDS) followed by rash and acute interstitial nephritis. These symptoms were improved by withdrawal of vancomycin and a pulsed corticosteroid regimen. According to the European Registry of Severe Cutaneous Adverse Reaction Criteria (RegiSCAR) (Kardaun et al, British Journal of Dermatology, 169:1071-1080, 2013), the probability of vancomycin induced DRESS syndrome was scored as “Definite”. A literature search of vancomycin induced DRESS syndrome was also performed and the overall pulmonary involvement was estimated as 5%. To our knowledge, this was the first case reported with pulmonary involvement as the initial symptom.

Conclusion

This is the first case to report pulmonary manifestation as the initial symptom in vancomycin induced DRESS syndrome. Prompt recognition of this entity can expedite proper treatment and hasten recovery.

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Title: Case report: atypical presentation of vancomycin induced DRESS syndrome: a case report and review of the literature
Authors: Olivia Wilcox
Mohamed Hassanein
John Armstrong
Nader Kassis
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Pulmonary Medicine / Issue 1/2017
Electronic ISSN: 1471-2466
DOI: https://doi.org/10.1186/s12890-017-0564-6

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