The drug rash with eosinophilia and systemic symptoms syndrome also known as DRESS syndrome refers to an idiosyncratic drug reaction commonly characterized by rashes, fever, lymphadenopathy, and internal organ involvement. We report a case of this syndrome in a 40-year-old man presenting with a rash, generalized pruritus, lymphadenopathy, and eosinophilia after metformin treatment. To the best of our knowledge, this is the first report linking metformin to the DRESS syndrome. The patient improved remarkably with drug withdrawal. A high index of clinical suspicion is emphasized to facilitate prompt diagnosis of medication related adverse effect and its discontinuation. In this article, we review the recent literature on DRESS syndrome.

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