Department of Immunology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
Department of Intensive Care Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.
BMJ Case Rep. 2021 Jan 18;14(1):e236966. doi: 10.1136/bcr-2020-236966.
Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is an important cause of multi-organ dysfunction and can mimic other disorders including sepsis. We describe a patient presenting with septic shock and accompanying high procalcitonin. Although initially treated empirically with antibiotics, the emergence of eosinophilia during the admission lead to a revised diagnosis of DRESS syndrome, presumed secondary to acetazolamide. This case highlights the importance of regular clinical assessment and re-evaluation is key in identifying emerging features such as eosinophilia, rash and organ dysfunction, which can secure the diagnosis. Furthermore, the case also highlights that acetazolamide may be a rare cause of DRESS syndrome.
药物反应伴嗜酸性粒细胞增多和全身症状（DRESS）综合征是多器官功能障碍的重要原因，可模拟包括脓毒症在内的其他疾病。我们描述了一位表现为感染性休克和伴随高降钙素原的患者。尽管最初经验性地使用抗生素治疗，但入院期间嗜酸性粒细胞增多导致修正诊断为 DRESS 综合征，推测继发于乙酰唑胺。本病例强调了定期临床评估和重新评估的重要性，这是识别新出现的特征（如嗜酸性粒细胞增多、皮疹和器官功能障碍）的关键，可明确诊断。此外，该病例还表明，乙酰唑胺可能是 DRESS 综合征的一个罕见原因。
