title: Drug rash with eosinophilia and systemic symptoms (DRESS) probably induced by cefotaxime: a report of two cases.
abstract: We report two cases, one of a 52-year-old man and one of a 32-year-old man, who were treated with cefotaxime. On day 23 and day 28 of the treatment, respectively, the patients manifested clinically with fever, pruriginous skin rash, and facial edema. Blood tests showed marked eosinophilia and atypical lymphocytosis for both patients, and hepatic cytolysis only in the second patient. Cefotaxime was discontinued in both patients; the clinico-biological picture improved gradually and completely disappeared approximately 4 weeks later. Six weeks after complete recovery, both patients underwent intradermal testing which was positive to cefotaxime (2 mg/ml) at the 48-hour reading and negative to benzylpenicillin, amoxicillin, and cefazolin at the 20-minute and 48-hour readings. These clinical pictures suggest drug rash with eosinophilia and systemic symptoms (DRESS) induced by cefotaxime. To the best of our knowledge, only one case of cefotaxime-induced DRESS has been reported in the medical literature. Thus, we add two new cases of cefotaxime-induced DRESS and emphasize the usefulness and safety of intradermal testing in establishing the diagnosis.
authors.affiliation: Pharmacology Department, University Hospital, Monastir, Tunisia. aouam_k@yahoo.fr
authors.forename: Karim
authors.initials: K
authors.lastname: Aouam
authors.forename: Amel
authors.initials: A
authors.lastname: Chaabane
authors.forename: Adnen
authors.initials: A
authors.lastname: Toumi
authors.forename: Nadia
authors.initials: N
authors.lastname: Ben Fredj
authors.forename: Foued
authors.initials: F
authors.lastname: Ben Romdhane
authors.forename: Naceur A
authors.initials: NA
authors.lastname: Boughattas
authors.forename: Mohamed
authors.initials: M
authors.lastname: Chakroun
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002439:Cefotaxime / Q000008:administration & dosage / Q000009:adverse effects*; D004487:Edema / Q000097:blood / Q000139:chemically induced / Q000473:pathology; D004802:Eosinophilia / Q000097:blood / Q000139:chemically induced / Q000473:pathology; D006801:Humans; D008218:Lymphocytosis / Q000097:blood / Q000139:chemically induced / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012871:Skin Diseases / Q000097:blood / Q000139:chemically induced / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D002439:Cefotaxime