engleski

DRESS syndrome to ciprofloxacin: a case report

Severe forms of cutaneous drug reactions associated with systemic symptoms are one of the biggest diagnostic and treatment challenges in allergology. Such reactions usually start several days to six weeks after drug introduction and occur in the form of changes on the skin and internal organs (liver, kidneys, lungs, etc.). Besides Toxic epidermal necrolysis (TEN) and Acute generalized exanthematous pustulosis (AGEP), there is a reaction called drug reaction with eosinophilia and systemic symptoms (DRESS), a form of hypersensitivity syndrome, which has a mortality of about 10%. We present a patient with pyelonephritis, treated with ciprofloxacin during emergency room workup. Finally, the patient was discharged, but, after ten days the patient came back with worsening condition, general inflammatory response, skin changes, liver and kidney damage, and eosinophilia. DRESS syndrome was diagnosed based on clinical and other findings. Mild forms of DRESS, as in our patient, in general recover spontaneously within weeks without the use of systemic corticosteroids. However, such cases require regular follow up of liver and kidney function, along with additional tests to exclude damage to other target organs, e.g., lungs, heart and thyroid gland. Early diagnosis of DRESS, identification of the etiology and therapy, starting with early discontinuation of the suspected drug, are most important in therapeutic process. For now, only elimination of the drug has a definitely proven therapeutic effect, therefore, early diagnosis is the key factor.

DRESS

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