title: Two cases of overlap severe cutaneous adverse reactions to benznidazole treatment for asymptomatic Chagas disease in a nonendemic country.
abstract: Chagas disease is a parasitosis endemic to South America. It is normally treated with benznidazole as first choice, which has been associated with numerous cutaneous reactions. However, very few benznidazole-associated severe cutaneous adverse reactions have been reported to date. The rise of Chagas disease in nonendemic countries represents a growing public health challenge. We report two patients who met the criteria for drug reaction with eosinophilia and systemic symptoms syndrome and Stevens-Johnson syndrome/toxic epidermal necrolysis according to the RegiSCAR scoring systems. They were thus deemed overlapping cases, with a lymphocyte transformation test positive for benznidazole. Both required intensive care unit admission and both survived. Considering the rising application of this drug for trypanosomiasis in immigrant populations, clinicians should be aware of this newly reported, potentially life-threatening risk.
authors: Department of Dermatology, La Paz University Hospital, Researching Consortium PIELenRed, Paseo La Castellana 261, CP 28046, Madrid, Spain. gnzalezramosjessica@gmail.com.
authors: J
authors: J
authors: González-Ramos
authors: Department of Dermatology, La Paz University Hospital, Researching Consortium PIELenRed, Paseo La Castellana 261, CP 28046, Madrid, Spain.
authors: L
authors: L
authors: Noguera-Morel
authors: Department of Clinical Pharmacology, La Paz University Hospital, Researching Consortium PIELenRed, Paseo La Castellana 261, CP 28046, Madrid, Spain.
authors: H Y
authors: HY
authors: Tong
authors: Department of Clinical Pharmacology, La Paz University Hospital, Researching Consortium PIELenRed, Paseo La Castellana 261, CP 28046, Madrid, Spain.
authors: E
authors: E
authors: Ramírez
authors: Department of Dermatopathology, La Paz University Hospital, Researching Consortium PIELenRed, Paseo La Castellana 261, CP 28046, Madrid, Spain.
authors: E
authors: E
authors: Ruiz-Bravo
authors: Research Department, La Paz University Hospital, Researching Consortium PIELenRed, Paseo La Castellana 261, CP 28046, Madrid, Spain.
authors: T
authors: T
authors: Bellón
authors: Department of Allergy, La Paz University Hospital, Researching Consortium PIELenRed, Paseo La Castellana 261, CP 28046, Madrid, Spain.
authors: R
authors: R
authors: Cabañas
authors: Department of Intensive Care Unit, La Paz University Hospital, Researching Consortium PIELenRed, Paseo La Castellana 261, CP 28046, Madrid, Spain.
authors: L
authors: L
authors: Cachafeiro
authors: Department of Dermatology, La Paz University Hospital, Researching Consortium PIELenRed, Paseo La Castellana 261, CP 28046, Madrid, Spain.
authors: P
authors: P
authors: Herranz-Pinto
mesh_terms: D000328:Adult; D014355:Chagas Disease / Q000188:drug therapy*; D003873:Dermatitis, Exfoliative / Q000139:chemically induced; D003875:Drug Eruptions / Q000209:etiology*; D004487:Edema / Q000139:chemically induced; D005260:Female; D006801:Humans; D008297:Male; D009593:Nitroimidazoles / Q000009:adverse effects*; D013262:Stevens-Johnson Syndrome / Q000175:diagnosis / Q000209:etiology*; D014344:Trypanocidal Agents / Q000009:adverse effects*
chemical_list: D009593:Nitroimidazoles; D014344:Trypanocidal Agents; C009999:benzonidazole