Abstract

PHENYTOIN INDUCED DRESS SYNDROME – A CASE REPORT

Dr. Chinnu Reeba George*, Dr. Priya Thomas, Dr. Jessy Thomas

ABSTRACT

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a delayed hypersensitivity reaction. It is characterised by fever, skin rash, haematological abnormalities and systemic involvement such as hepatitis. This usually presents 2-6weeks after drug initiation. Here we present a case of DRESS syndrome due to phenytoin exposure 4 weeks after drug initiation in a 63year old male patient. Laboratory investigations revealed atypical lymphocytosis, eosinophilia and elevated liver enzymes. Immediate cessation of phenytoin and initiation of corticosteroid therapy were the main stay of management. Early recognition of drug reaction with eosinophilia and systemic symptoms syndrome and initiation of appropriate therapy are imperative in limiting morbidity.

Keywords: DRESS syndrome, phenytoin, eosinophilia, maculopapular rashes.