Drug-induced hypersensitivity syndrome due to carbapenem antibiotics.
Drug-induced hypersensitivity syndrome (DIHS) is characterized by a serious adverse systemic reaction that usually appears after a 3-6-week exposure to certain drugs, for example, anticonvulsants. Many different precipitating factors have been reported, but the pathophysiology of DIHS remains unknown. However, reactivation of members of the human herpesvirus (HHV) family, and of HHV-6 in particular, has been reported in patients with DIHS. We report the case of a 64-year-old man who developed a generalized erythematous rash, fever, hepatic failure, lymphadenopathy and an increased number of atypical lymphocytes. In addition, reactivation of HHV-6 and cytomegalovirus (CMV) was demonstrated by real-time quantitative amplification by polymerase chain reaction. The patient was given a diagnosis of DIHS due to carbapenem antibiotics based on his clinical course, laboratory data, and results of lymphocyte-stimulation tests with various drugs. This is the first report, to our knowledge, of DIHS induced by carbapenem antibiotics.
Goto
Mizuki
M
Department of Dermatology, Faculty of Medicine, Oita University, Yufu, Japan. gotomizu@med.oita-u.ac.jp
Shimizu
Fumiaki
F
Takeo
Naoko
N
Okamoto
Osamu
O
Katagiri
Kazumoto
K
Ikewaki
Junji
J
Ogata
Masao
M
Kadota
Jun-ichi
J
Fujiwara
Sakuhei
S
D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D015780:Carbapenems / Q000008:administration & dosage / Q000009:adverse effects*; D003520:Cyclophosphamide / Q000008:administration & dosage; D003587:Cytomegalovirus / Q000187:drug effects*; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D004317:Doxorubicin / Q000008:administration & dosage; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000473:pathology / Q000821:virology*; D005076:Exanthema / Q000175:diagnosis / Q000473:pathology / Q000821:virology; D005334:Fever / Q000175:diagnosis / Q000821:virology; D015654:Herpesvirus 6, Human / Q000187:drug effects*; D006801:Humans; D017093:Liver Failure / Q000175:diagnosis / Q000473:pathology / Q000821:virology; D008206:Lymphatic Diseases / Q000175:diagnosis / Q000473:pathology / Q000821:virology; D020522:Lymphoma, Mantle-Cell / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage; D000069283:Rituximab; D019349:Roseolovirus Infections / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D013577:Syndrome; D014750:Vincristine / Q000008:administration & dosage; D014775:Virus Activation / Q000187:drug effects*
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D015780:Carbapenems; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011239:Prednisolone