English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

We present the case of a 62-year-old Caucasian man who was being treated for mitral valve endocarditis via a six-week course of vancomycin. On Day 32 of the treatment, he developed an erythematous, pruritic, desquamating, and painful rash covering 80% of the total body surface area and intermittent fevers. Laboratory findings included leukocytosis with peripheral blood eosinophilia and elevated erythrocyte sedimentation rate, C-reactive protein, and serum creatinine.  Although the patient only completed five weeks of antibiotics, the decision was made to not complete the six-week antibiotic course due to suspicion of vancomycin-induced drug rash with eosinophilia and systemic symptoms (DRESS). The patient was then given 80 mg of intramuscular triamcinolone (Kenalog) and advised to apply topical 0.1% triamcinolone twice per day. At the three-month follow-up, the rash, leukocytosis, eosinophilia, and renal dysfunction had resolved. Clinicians must maintain a high index of suspicion for vancomycin-induced DRESS in patients with rash and eosinophilia for early recognition and treatment.  DRESS syndrome treatment typically involves discontinuing the causative drug and promptly administering steroids. However, there is a therapeutic dilemma in administering steroids during the course of an active infection. Therefore, this article serves two purposes. First, this case report highlights our approach towards managing a patient with DRESS and concurrent infectious endocarditis. Second, we include a review of the management considerations when prescribing pulsed steroids so that clinicians have a single source as a practical guide towards reducing the potentially severe systemic sequelae in DRESS syndrome and its associated treatment.

curēus

Drug Rash with Eosinophilia and Systemic Symptoms Syndrome Presenting After the Initiation of Staphylococcus hominis Infectious Endocarditis Treatment: A Case Report and Updated Review of Management Considerations