DRESS syndrome on the background of adding meropenem to carbamazepine therapy: a clinical case
Yu. V. Ilina,
T. A. Fedorova,
S. Y. Tazina,
T. I. Sotnikova,
N. A. Semenenko,
N. V. Loshchits,
S. A. Bolshakov,
N. V. Kiseleva,
Ch. S. Pavlov https://doi.org/10.47093/2218-7332.2022.407.09
Abstract
DRESS syndrome is a life-threatening complication rarely encountered in clinical practice. Making a correct diagnosis is complicated not only by the similarity of the clinical manifestation with several other conditions but also delayed in time onset of the first symptoms from the “causative” drug. Along with that, timely diagnosis and early treatment reduce the risk of severe course and complications of the syndrome.
Clinical case. A 29-year-old female patient was admitted to the hospital due to generalized maculopapular rash, fever, generalized lymphadenopathy, fatigue, splenomegaly appeared after adding meropenem to carbamazepine therapy. Blood tests showed leukocytosis – 33.6×109/l, hypereosinophilia – 7.9×109/l, elevated liver transaminases. After exclusion of autoimmune, infectious and oncohematological diseases the diagnose of DRESS syndrome was established. On the background of methylprednisolone therapy at the dose of 1 mg/kg fast normalization of body temperature, disappearance of rash, decrease in eosinophils were observed.
Discussion. The specific feature of this clinical case is the development of DRESS syndrome after adding antibiotic to anticonvulsant drug (with which this syndrome is commonly associated). This fact complicated the diagnosis. Raising doctors’ awareness about the possibility of developing such an adverse reaction to antibiotic therapy seems to be extremely important to improve the prognosis of this group of patients.
About the Authors
Yu. V. Ilina
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Yulia V. Ilina, Cand. of Sci. (Medicine), Associate Professor, Therapy Department
Address: 8/2, Trubetskaya str., Moscow, 119991
Tel.: +7 (495) 623-13-76
T. A. Fedorova
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Tatiana A. Fedorova, Dr. of Sci. (Medicine), Professor, Therapy Department
8/2, Trubetskaya str., Moscow, 119991
S. Y. Tazina
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Serafima Y. Tazina, Dr. of Sci. (Medicine), Professor, Therapy Department
8/2, Trubetskaya str., Moscow, 119991
T. I. Sotnikova
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Tatiana I. Sotnikova, Cand. of Sci. (Medicine), Associate Professor, Therapy Department
8/2, Trubetskaya str., Moscow, 119991
N. A. Semenenko
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Natalya A. Semenenko, Cand. of Sci. (Medicine), Associate Professor, Therapy Department
8/2, Trubetskaya str., Moscow, 119991
N. V. Loshchits
City Clinical Hospital named after S.P. Botkin of the Moscow Healthcare Department
Russian Federation
Russian Federation
Natalia V. Loshchits, Head of Therapy Department No. 2
5, 2nd Botkinsky proezd, Moscow, 125284
S. A. Bolshakov
City Clinical Hospital named after S.P. Botkin of the Moscow Healthcare Department
Russian Federation
Russian Federation
Stepan A. Bolshakov, doctor at Therapy Department No. 2
5, 2nd Botkinsky proezd, Moscow, 125284
N. V. Kiseleva
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Nataliia V. Kiseleva, clinical resident, Therapy Department
8/2, Trubetskaya str., Moscow, 119991
Ch. S. Pavlov
Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation
Russian Federation
Chavdar S. Pavlov, Dr. of Sci. (Medicine), Professor, Head of Therapy Department, Institute of Professional Education
8/2, Trubetskaya str., Moscow, 119991
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