Khanth P E Sanjeev, Thangaraju Pugazhenthan, Gaikwad Nitin R, Wasnik Preetam N
Department of Pharmacology, All India Institute of Medical Sciences, Raipur, India.
Department of General Medicine, All India Institute of Medical Sciences, Raipur, India.
Curr Drug Saf. 2025;20(4):514-518. doi: 10.2174/0115748863333025241113055751.
The Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) is a serious adverse reaction that occurs weeks after the onset of drug exposure. DRESS syndrome is commonly associated with antiseizure drugs, sulfa drugs, and antibiotics.
This was a case report of a 20-year-old female who suffered from DRESS due to vancomycin with symptoms similar to the Redman syndrome. The patient was a case of Infective endocarditis due to methicillin-resistant (MRSA), and vancomycin was intravenously administered. On the 18th day, during the administration of vancomycin, the patient developed sudden severe flushing over the face and trunk. The offending drug was suspended and treated with antihistamines in view of Redman syndrome. Later, the patient developed uncontrolled fever, desquamating rash all over the body, severe pruritis, and eosinophilia. On applying the RegiScar score, a probable case of DRESS was diagnosed. The patient was managed symptomatically and discharged.
The clinical presentation of DRESS includes skin rash, fever, eosinophilia, and organ involvement. But, in this case, there was a varied initial presentation of DRESS with severe flushing, which mimics the Redman syndrome due to vancomycin. Difficulty in establishing organ involvement remained a challenge in diagnosing DRESS.
DRESS can have a varied clinical presentation. Careful monitoring of all vital parameters is important in preventing the misdiagnosis of DRESS syndrome.
药物超敏反应伴嗜酸性粒细胞增多和全身症状（DRESS）是一种在接触药物数周后发生的严重不良反应。DRESS综合征通常与抗癫痫药物、磺胺类药物和抗生素有关。
这是一例20岁女性因万古霉素导致DRESS的病例报告，其症状类似于红人综合征。该患者为耐甲氧西林金黄色葡萄球菌（MRSA）引起的感染性心内膜炎，接受了万古霉素静脉给药治疗。在第18天，万古霉素给药期间，患者面部和躯干突然出现严重潮红。鉴于红人综合征，停用了可疑药物并用抗组胺药进行治疗。后来，患者出现持续发热、全身脱屑性皮疹、严重瘙痒和嗜酸性粒细胞增多。应用RegiScar评分，诊断为可能的DRESS病例。对患者进行了对症治疗并出院。
DRESS的临床表现包括皮疹、发热、嗜酸性粒细胞增多和器官受累。但是，在本病例中，DRESS最初表现多样，有严重潮红，类似于万古霉素引起的红人综合征。确定器官受累情况在诊断DRESS时仍然是一项挑战。
DRESS可具有多样的临床表现。仔细监测所有重要参数对于预防DRESS综合征的误诊很重要。
