title: DRESS syndrome in ophthalmic patients.
abstract: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and potentially fatal adverse drug reaction associated with skin rash, fever, eosinophilia, and multiple organ injury. A number of pharmacological agents are known to cause DRESS syndrome such as allopurinol, anticonvulsants, vancomycin, trimethoprime-sulfamethoxazole, and pyrimethamine-sulfadiazine. Here, we describe two patients who developed DRESS syndrome during ocular treatment. The first case was being treated for late postoperative endophthalmitis with topical antibiotics, intravenous cephalothin, meropenem, and intravitreal injection of vancomycin and ceftazidime before symptoms developed. We were unable to identify the causal drug owing to the large number of medications concurrently administered. The second case presented with DRESS syndrome symptoms during ocular toxoplasmosis treatment. In this case, a clearer association with pyrimethamine-sulfadiazine was observed. As a result of the regular prescription of pharmacological agents associated with DRESS syndrome, ophthalmologists should be aware of the potentially serious complications of DRESS syndrome.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Jacqueline Martins de
authors.initials: JM
authors.lastname: Sousa
authors.affiliation: Department of Ophthalmology and Visual Sciences, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Heloisa
authors.initials: H
authors.lastname: Nascimento
authors.affiliation: Department of Ophthalmology and Visual Sciences, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
authors.forename: Rubens
authors.initials: R
authors.lastname: Belfort
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D000981:Antiprotozoal Agents / Q000009:adverse effects*; D001706:Biopsy; D063926:Drug Hypersensitivity Syndrome / Q000209:etiology* / Q000473:pathology*; D009877:Endophthalmitis / Q000188:drug therapy; D005260:Female; D005334:Fever / Q000473:pathology; D006801:Humans; D058449:Intravitreal Injections / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000473:pathology; D014126:Toxoplasmosis, Ocular / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D000981:Antiprotozoal Agents