Infect Chemother.  2012 Jun;44(3):197-200. 10.3947/ic.2012.44.3.197.

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome Induced by Ethambutol and Rifampin

Affiliations
  • 1Department of Internal Medicine, Gachon University of Medicine and Science, Incheon, Korea. yspark@gilhospital.com
  • 2Department of Dermatology, Gachon University of Medicine and Science, Incheon, Korea.
  • 3Department of Laboratory Medicine, Gachon University of Medicine and Science, Incheon, Korea.

Abstract

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a disorder which can be caused by treatment with a diverse collection of drugs, and it is characterized by fever, rash, lymphadenopathy, and internal organ involvement with eosinophilia. Although ethambutol and rifampin are popularly used to treat tuberculosis, there has been only one reported case of DRESS syndrome associated with ethambutol. DRESS syndrome associated with administration of rifampin have not been reported. In this report and discussion, we present the case of a patient suffering from DRESS syndrome induced by both ethambutol and rifampin.

Keyword

Ethambutol; Rifampin; DRESS syndrome

MeSH Terms

Eosinophilia
Ethambutol
Exanthema
Fever
Humans
Lymphatic Diseases
Rifampin
Stress, Psychological
Tuberculosis
Ethambutol
Rifampin

Figure

  • Figure 1 The rash extended on the patient's face (A) and entire body (B).

  • Figure 2 There was perivascular lymphocytic infiltration and vasodilation of the upper dermis (hematoxylin-eosin staining, magnification ×100).

  • Figure 3 Laboratory data from admission to discharge (the solid arrow indicates the ethambutol challenge and the dashed arrow indicates the rifampin challenge).


Cited by  2 articles

Prevalence and Clinical Features of Drug Reactions With Eosinophilia and Systemic Symptoms Syndrome Caused by Antituberculosis Drugs: A Retrospective Cohort Study
Ho Yeon Jung, Sunmin Park, Beomsu Shin, Ji-Ho Lee, Seok Jeong Lee, Myoung Kyu Lee, Won-Yeon Lee, Suk Joong Yong, Sang-Ha Kim
Allergy Asthma Immunol Res. 2019;11(1):90-103.    doi: 10.4168/aair.2019.11.1.90.

DRESS (drug reaction with eosinophilia and systemic symptom) syndrome caused by both first-line and second-line antitubercular medications: A case report with a brief literature review
Young-Hoon Hwang, Dong Yeon Jang, Sung Yoon Kang, Kyung-Hee Sohn, Dong Yoon Kang, Chang Hoon Lee, Hye-Ryun Kang
Allergy Asthma Respir Dis. 2017;5(2):111-116.    doi: 10.4168/aard.2017.5.2.111.


Reference

1. Takami A, Nakao S, Asakura H, Yamazaki H, Mizuhashi K, Matsuda T, Mizushima N. Pneumonitis and eosinophilia induced by ethambutol. J Allergy Clin Immunol. 1997. 100:712–713.
Article
2. Lee JH, Park HK, Heo J, Kim TO, Kim GH, Kang DH, Song GA, Cho M, Kim DS, Kim HW, Lee CH. Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome induced by celecoxib and anti-tuberculosis drugs. J Korean Med Sci. 2008. 23:521–525.
Article
3. Pegram PS Jr, Mountz JD, O'Bar PR. Ethambutol-induced toxic epidermal necrolysis. Arch Intern Med. 1981. 141:1677–1678.
Article
4. Surjapranata FJ, Rahaju NN. A case of Stevens-Johnson's syndrome caused by ethambutol. Paediatr Indones. 1979. 19:195–201.
Article
5. Ben'mrad M, Leclerc-Mercier S, Blanche P, Franck N, Rozenberg F, Fulla Y, Guesmi M, Rollot F, Dehoux M, Guillevin L, Moachon L. Drug-induced hypersensitivity syndrome: clinical and biologic disease patterns in 24 patients. Medicine (Baltimore). 2009. 88:131–140.
Article
6. Chen YC, Chiu HC, Chu CY. Drug reaction with eosinophilia and systemic symptoms: a retrospective study of 60 cases. Arch Dermatol. 2010. 146:1373–1379.
Article
7. Bocquet H, Bagot M, Roujeau JC. Drug-induced pseudolymphoma and drug hypersensitivity syndrome (Drug Rash with Eosinophilia and Systemic Symptoms: DRESS). Semin Cutan Med Surg. 1996. 15:250–257.
Article
8. Walsh SA, Creamer D. Drug reaction with eosinophilia and systemic symptoms (DRESS): a clinical update and review of current thinking. Clin Exp Dermatol. 2011. 36:6–11.
Article
9. Tas S, Simonart T. Management of drug rash with eosinophilia and systemic symptoms (DRESS syndrome): an update. Dermatology. 2003. 206:353–356.
10. Wolf R, Matz H, Marcos B, Orion E. Drug rash with eosinophilia and systemic symptoms vs toxic epidermal necrolysis: the dilemma of classification. Clin Dermatol. 2005. 23:311–314.
11. Descamps V, Valance A, Edlinger C, Fillet AM, Grossin M, Lebrun-Vignes B, Belaich S, Crickx B. Association of human herpesvirus 6 infection with drug reaction with eosinophilia and systemic symptoms. Arch Dermatol. 2001. 137:301–304.
12. Sullivan JR, Shear NH. The drug hypersensitivity syndrome: what is the pathogenesis? Arch Dermatol. 2001. 137:357–364.
Full Text Links
  • IC
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr