Fulminant Type 1 Diabetes in the Course of Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome

DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms) syndrome is a life-threatening drug reaction. Its management relies on discontinuation of the culprit drug and treatment with corticosteroids (1).A 68-year-old Filipino woman was admitted for ketoacidosis (DKA), revealing diabetes. Four months before admission, she had been treated for bronchitis with erythromycin, then moxifloxacin. A transient skin rash occurred. Six days before admission, she was treated with amoxicillin/clavulanic acid for recurrence of bronchitis, and fever and a pruritic skin rash occurred. Four days later, the patient was admitted for drowsiness, tachypnea, and vomiting. She reported no abdominal pain, no weight loss (BMI 20.3 kg/m2), and no polyuria. Physical examination disclosed facial erythema, palpebral edema, conjunctivitis, generalized maculopapular skin rash, cheilitis, and diffuse lymph node …