Allergy Asthma Respir Dis.  2016 Jan;4(1):74-78. 10.4168/aard.2016.4.1.74.

Rapid-onset of severe tigecycline-induced coagulopathy in drug reaction with eosinophilia and systemic symptom syndrome

• Jeong YJ
• Ghanh B
• Lee JW
• Park J
• Kim TB
• Cho YS
• Moon HB
• Kwon HS

• KMID: 2218624
• DOI: http://doi.org/10.4168/aard.2016.4.1.74

Abstract

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome-also known as drug-induced hypersensitivity syndrome-is an uncommon disease entity that manifests as fever, skin rash, blood cell abnormalities, lymphadenopathy, and often coagulopathy. Tigecycline is an antibiotic that is selectively used to treat complicated intra-abdominal and soft-tissue infections. Recently, a few cases of tigecycline-induced coagulopathy have been reported. Herein, we report a case of tigecycline-induced coagulopathy in a patient with DRESS syndrome. Both prothrombin time and activated partial thromboplastin time were abruptly exceeded beyond 180 seconds on day 6 of tigecycline treatment and normalized after discontinuation of tigecycline.

Keyword

DRESS syndrome; Tigecycline; Coagulopathy

MeSH Terms

Blood Cells
Drug Hypersensitivity Syndrome
Eosinophilia*
Exanthema
Fever
Humans
Hypersensitivity
Lymphatic Diseases
Partial Thromboplastin Time
Prothrombin Time

Figure

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  Fig. 1 Generalized maculopapular rash and petechiae on the lower extremities

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  Fig. 2 High-resolution chest computed tomography images showing pulmonary edema (A) and mediastinal lymphadenopathy (B; arrow, mediastinal lymphadenom). DRESS syndrome can manifest interstitial pneumonia and pleural effusion.

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  Fig. 3 Skin biopsy showing dermatitis with perivascular lymphocytic and eosinophilic infiltration (H&E, ×400).

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