CMV complications in DIHS/DRESS: Importance of routine monitoring and early therapeutic intervention.

The fatal outcomes in DIHS/DRESS are reported to be associated with CMV reactivation. However, CMV reactivation is also observed not only in DIHS/DRESS but also in other diseases when high doses of corticosteroids are administered. Currently, it is difficult to distinguish whether CMV reactivation in DIHS/DRESS is caused by steroid-induced immunosuppression or the pathology of DIHS/DRESS. In this study, we describe the characteristic of CMV reactivation in patients with DIHS/DRESS (n=22) by comparing the frequency of reactivation and its complication with those with pemphigus vulgaris (PV) (n=21) treated with high dose of corticosteroids. The frequency of CMV reactivation showed no difference between DIHS/DRESS and PV. On the other hand, the frequency of CMV complication was higher in DIHS than PV. Our data shows the importance of monitoring the CMV complication while CMV reactivation is not unique consequence of DIHS/DRESS compared to diseases treated with high dose of corticosteroids.