Ciprofloxacin Ophthalmic DRESS Syndrome: Case Report
Main Article Content
Abstract
Introduction: Drug rash with eosinophilia and systemic symptoms (DRESS syndrome), also known as drug-induced hypersensitivity syndrome, is a rare severe systemic hypersensitivity drug reaction. Diagnosing DRESS syndrome is challenging due to non-specific manifestations that can make it difficult to recognize. Therefore, addressing and discussing this issue is extremely important, considering the potential lethality of a treatable syndrome.
Clinical case: We describe the clinical characteristics of a 39-year-old female who presented with DRESS syndrome associated with the use of ciprofloxacin ophthalmic. The patient manifested a mild maculopapular rash located in the pelvic limbs with subsequent ascending distribution and generalized erythematoviolaceous affecting four extremities, trunk, facial region and scalp, together with fever and lymphadenopathy. Paraclinical tests revealed leukocytosis and eosinophilia. According to RegiScar's ranking, it scored 6 points, classifying it as the definitive case for DRESS. He concluded a schedule with prednisone 1 mg/kg/day with a slow reduction dose, obtaining a good response to treatment.
Conclusions: DRESS syndrome should be suspected in a patient receiving medical treatment who presents with the following signs and symptoms: rash, fever (38°C), facial edema, and lymphadenopathy. Fortunately, this reaction is usually reversible, with a low incidence of residual damage or mortality, in the case of timely discontinuation of antibiotics and use of topical or systemic corticosteroids.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
I. Isaacs M, Cardones AR, Rahnama-Moghadam S. DRESS Syndrome: Clinical Myths and Pearls. CUTIS . 2018 Nov;102(5):322–6.
II. Descamps V, Ranger-Rogez S. Dress syndrome. Joint Bone Spine. 2014;81(1):15–21. doi:10.1016/j.jbspin.2013.05.002
III. Fernando SL. Drug-reaction eosinophilia and systemic symptoms and drug-induced hypersensitivity syndrome. Australasian Journal of Dermatology. 2013;55(1):15–23. doi:10.1111/ajd.12085
IV. Corneli H. DRESS Syndrome: Drug Reaction With Eosinophilia and Systemic Symptoms. Pediatric Emergency Care. 2017 Jul;33(7):499–504. doi:10.1097/PEC.0000000000001188
V. Contreras DM, Torres JMZ, Gutiérrez GJG, et al. DRESS syndrome by sulfonamides, about a case. Int J Basic Clin Pharmacol 2022;11:465-9. DOI:
VI. 10.18203/2319-2003.ijbcp20222051
VII. Silva SA, Figueiredo MM, Carneiro Neto L, et al. Drug reaction with eosinophilia and systemic symptoms (DRESS syndrome). Revista da Associação Médica Brasileira. 2016;62(3):227–30. doi:10.1590/1806-9282.62.03.227
VIII. Cardones AR. Drug reaction with eosinophilia and systemic symptoms (dress) syndrome. Clinics in Dermatology. 2020;38(6):702–11. doi:10.1016/j.clindermatol.2020.06.008
IX. Adwan MH. Drug reaction with eosinophilia and systemic symptoms (dress) syndrome and the rheumatologist. Current Rheumatology Reports. 2017;19(1). doi:10.1007/s11926-017-0626-z
X. Sharifzadeh S, Mohammadpour AH, Tavanaee A, et al. Antibacterial antibiotic-induced drug reaction with eosinophilia and systemic symptoms (dress) syndrome: A literature review. European Journal of Clinical Pharmacology. 2020;77(3):275–89. doi:10.1007/s00228-020-03005-9
XI. Heymann WR. The diagnostic criteria of Dress syndrome must be addressed. Journal of the American Academy of Dermatology. 2020;82(3):573–4. doi:10.1016/j.jaad.2019.12.057
XII. Sahnoun R, El Aïdli S, Zaïem A, et al. Dress syndrome à la ciprofloxacine. Néphrologie & Thérapeutique. 2015;11(2):111–3. doi:10.1016/j.nephro.2014.11.004
XIII. Shiohara T, Mizukawa Y. Drug-induced hypersensitivity syndrome (dihs)/drug reaction with eosinophilia and systemic symptoms (dress): An update in 2019. Allergology International. 2019;68(3):301–8. doi:10.1016/j.alit.2019.03.006
XIV. Zafar S, Decastro A, Pal S, et al. Vancomycin-induced dress syndrome. Annals of Allergy, Asthma & Immunology. 2020;124(1):107–8. doi:10.1016/j.anai.2019.09.002
XV. Descamps V, Ben Saïd B, Sassolas B, et al. Prise en charge du drug reaction with eosinophilia and systemic symptoms (dress). Annales de Dermatologie et de Vénéréologie. 2010;137(11):703–8. doi:10.1016/j.annder.2010.04.024
XVI. Behera SK, Das S, Xavier AS, et al. Dress syndrome: A detailed insight. Hospital Practice. 2018;46(3):152–62. doi:10.1080/21548331.2018.1451205
XVII. Girelli F, Bernardi S, Gardelli L, et al. A new case of dress syndrome induced by sulfasalazine and triggered by Amoxicillin. Case Reports in Rheumatology. 2013;2013:1–3.
doi:10.1155/2013/409152
XVIII. Sharpe A, Mourad BM, Hardwick CJ, et al. Oxacillin-induced drug reaction with eosinophilia and systemic symptoms (dress). American Journal of Case Reports. 2019;20:345–8. doi:10.12659/ajcr.913748
XIX. Hagihara M, Yamagishi Y, Hirai J, et al. Drug-induced hypersensitivity syndrome by liposomal amphotericin-B: A case report. BMC Research Notes. 2015;8(1). doi:10.1186/s13104-015-1486-0
XX. Littlehales E, Murray O, Dunsmuir R. Vancomycin-induced dress syndrome: An important concern in orthopedic surgery. Case Reports in Orthopedics. 2018;2018:1–5. doi:10.1155/2018/1439073
XXI. Lee J-Y, Seol Y-J, Shin D-W, et al. A case of the drug reaction with eosinophilia and systemic symptom (dress) following isoniazid treatment. Tuberculosis and Respiratory Diseases. 2015;78(1):27. doi:10.4046/trd.2015.78.1.27