Sulfasalazine-induced drug reaction with eosinophilia and systemic symptoms (DRESS) with concomitant acute chikungunya virus infection: possible role of new viral trigger.
Abheek SilMoni Sankar BhattacharjeeAtanu ChandraJayasri Das PramanikPublished in: BMJ case reports (2021)
Drug reaction with eosinophilia and systemic symptoms (DRESS) is designated as a potentially lethal adverse drug effect with characteristic signs and symptoms such as skin rash, fever, leucocytosis with eosinophilia or atypical lymphocytes, lymphadenopathy and liver or renal dysfunction. In addition to most commonly implicated drug category (aromatic anticonvulsants), lamotrigine, sulfonamides, dapsone and abacavir may also induce this syndrome. We describe here a case a sulfasalazine-induced DRESS with coexisting chikungunya fever. The shared presentation of fever with rash in both conditions made it a challenging diagnosis. Sulfasalazine hypersensitivity manifesting as DRESS has rarely been reported. Furthermore, we document chikungunya virus (CV) as a possible triggering agent for DRESS. To the best of our knowledge, CV as a viral aetiology in DRESS has not been reported previously in the literature.
Keyphrases
- drug induced
- adverse drug
- zika virus
- aedes aegypti
- high glucose
- dengue virus
- sars cov
- diabetic rats
- oxidative stress
- emergency department
- systematic review
- sleep quality
- case report
- healthcare
- endothelial cells
- liver failure
- physical activity
- mass spectrometry
- soft tissue
- depressive symptoms
- mechanical ventilation
- high resolution
- intensive care unit
- simultaneous determination