[Rash, fever, eosinophilia and elevated liver enzymes. DRESS syndrome (drug reaction or rash with eosinophilia and systemic symptoms)].
We report on a patient with Pneumocystis jirovecii pneumonia who developed fever, rash, eosinophilia and hepatitis 10 days after initiation of a therapy with sulfamethoxazole and trimethoprim. A DRESS syndrome was diagnosed and the therapy was changed successfully to pyrimethamine and dapsone. We describe the clinical picture, causative drugs, pathogenesis, differential diagnoses and therapy of this life-threatening disease to acquaint the general practitioner with it.
Derungs
Adrian
A
Abteilung für Klinische Pharmakologie und Toxikologie, Departement Innere Medizin, Universitätsspital Basel. DerungsA@uhbs.ch
Rätz Bravo
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AE
Kummer
O
O
D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000009:adverse effects; D003937:Diagnosis, Differential; D004317:Doxorubicin / Q000008:administration & dosage / Q000009:adverse effects; D003875:Drug Eruptions / Q000175:diagnosis*; D004342:Drug Hypersensitivity / Q000175:diagnosis*; D004802:Eosinophilia / Q000209:etiology*; D005076:Exanthema / Q000209:etiology*; D005335:Fever of Unknown Origin / Q000209:etiology*; D006801:Humans; D008111:Liver Function Tests; D016399:Lymphoma, T-Cell / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000139:chemically induced / Q000188:drug therapy*; D045363:Pneumocystis carinii; D011020:Pneumonia, Pneumocystis / Q000139:chemically induced / Q000188:drug therapy*; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D000069283:Rituximab; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects* / Q000627:therapeutic use*; D014750:Vincristine / Q000008:administration & dosage / Q000009:adverse effects
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D003520:Cyclophosphamide; D011241:Prednisone