Red Herring in Returned Traveler: Drug Reaction With Eosinophilia and Systemic Symptom (DRESS) Syndrome Mimicking Sepsis | Zendy

Hui Yin Lim | Zendy; Gene Khai Lin Huang | Zendy; Joseph Torresi | Zendy; Douglas Johnson | Zendy

Open Access

Red Herring in Returned Traveler: Drug Reaction With Eosinophilia and Systemic Symptom (DRESS) Syndrome Mimicking Sepsis

Author(s) -

Hui Yin Lim,

Gene Khai Lin Huang,

Joseph Torresi,

Douglas Johnson

Publication year - 2014

Publication title -

journal of travel medicine

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 1.985

H-Index - 59

eISSN - 1708-8305

pISSN - 1195-1982

DOI - 10.1111/jtm.12152

Subject(s) - medicine , eosinophilia , maculopapular rash , sepsis , skin biopsy , dermatology , drug allergy , allopurinol , differential diagnosis , prednisolone , travel medicine , rash , culprit , surgery , pathology , biopsy , immunology , allergy , myocardial infarction

We report a case of a 51-year-old Han Chinese recently returned traveler, who was admitted with a generalized maculopapular rash, fevers, shock, and multi-organ failure. Extensive investigations failed to reveal an infective cause. Skin biopsy findings together with the recent commencement of allopurinol raised a diagnosis of drug reaction with eosinophilia and systemic symptom syndrome. High-dose prednisolone was commenced and the patient made a rapid recovery. This case highlights that not all sepsis-like presentations in returned travelers are due to infective causes and that severe drug reactions need to be considered in the differential diagnosis.

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