title: Red herring in returned traveler: drug reaction with eosinophilia and systemic symptom (DRESS) syndrome mimicking sepsis.
abstract: We report a case of a 51-year-old Han Chinese recently returned traveler, who was admitted with a generalized maculopapular rash, fevers, shock, and multi-organ failure. Extensive investigations failed to reveal an infective cause. Skin biopsy findings together with the recent commencement of allopurinol raised a diagnosis of drug reaction with eosinophilia and systemic symptom syndrome. High-dose prednisolone was commenced and the patient made a rapid recovery. This case highlights that not all sepsis-like presentations in returned travelers are due to infective causes and that severe drug reactions need to be considered in the differential diagnosis.
authors.affiliation: Department of General Medicine, Austin Health, Heidelberg, Australia.
authors.forename: Hui Yin
authors.initials: HY
authors.lastname: Lim
authors.forename: Gene Khai Lin
authors.initials: GK
authors.lastname: Huang
authors.forename: Joseph
authors.initials: J
authors.lastname: Torresi
authors.forename: Douglas
authors.initials: D
authors.lastname: Johnson
mesh_terms: D000493:Allopurinol / Q000009:adverse effects*; D001315:Australia; D002681:China; D003937:Diagnosis, Differential; D063926:Drug Hypersensitivity Syndrome / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology; D004802:Eosinophilia / Q000139:chemically induced*; D005260:Female; D005334:Fever / Q000139:chemically induced; D006074:Gout Suppressants / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D011697:Purpura, Thrombotic Thrombocytopenic / Q000139:chemically induced; D018805:Sepsis / Q000175:diagnosis; D012867:Skin / Q000473:pathology; D014195:Travel
chemical_list: D006074:Gout Suppressants; D000493:Allopurinol