title: DRESS syndrome with mild manifestations as a diagnostic and therapeutic problem: case report.
abstract: The group of severe cutaneous drug reactions with systemic symptoms includes several syndromes: toxic epidermal necrolysis, Stevens-Johnson syndrome, acute generalized exanthematous pustulosis, and drug reaction with eosinophilia and systemic symptoms (DRESS). These reactions occur several days to six weeks after introducing the incriminating drug. The skin and internal organs (liver, kidneys, lungs, etc.) are usually involved. A great possibility of lethal outcome is a critical characteristic of these syndromes. A patient with pyelonephritis diagnosed during emergency room workup is described. Ciprofloxacin was prescribed and the patient was discharged. After ten days, the patient came back with worsening condition, general inflammatory response, skin changes, liver and kidney damage, and eosinophilia. DRESS syndrome was diagnosed based on clinical and other findings. The diagnosis and treatment of severe drug reactions with cutaneous and systemic symptoms pose a medical challenge.
authors.affiliation: University Department of Internal Medicine, Sveti Duh University Hospital, Zagreb, Croatia. marinko.artukovic@zg.t-com.hr
authors.forename: Marinko
authors.initials: M
authors.lastname: Artuković
authors.forename: Josipa
authors.initials: J
authors.lastname: Kustelega
authors.forename: Liborija
authors.initials: L
authors.lastname: Lugović-Mihić
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002939:Ciprofloxacin / Q000009:adverse effects*; D003937:Diagnosis, Differential; D003875:Drug Eruptions / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D004802:Eosinophilia / Q000150:complications*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced; D008875:Middle Aged; D013577:Syndrome
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin