The Treatment of Obstinate Chorea With Nirvanol

Jones, T. Duckett

doi:10.1001/jama.1932.02740530020006

Cited by 15 publications

(2 citation statements)

References 9 publications

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“…The term DRESS was first proposed in 1996, though medical providers had likely been encountering this severe cutaneous adverse reaction (SCAR) since the advent of hydantoin derivatives for the treatment of convulsive disorders [ 3 , 4 ]. First described in 1959, as a pseudolymphoma often accompanied by exanthem, eosinophilia, and fever, this potentially fatal SCAR has been known by a variety of names including drug-induced hypersensitivity syndrome, drug-induced delayed multiorgan hypersensitivity syndrome, anticonvulsant hypersensitivity syndrome, and phenytoin syndrome [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

Drug Reaction with Eosinophilia and Systemic Symptoms: DRESS following Initiation of Oxcarbazepine with Elevated Human Herpesvirus-6 Titer

Cornell

DiBlasi

Arora

2014

Case Reports in Dermatological Medicine

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Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare and potentially fatal severe cutaneous reaction, which has a delayed onset after the initiation of an inciting medication. After recognition and withdrawal of the causative agent, along with aggressive management, a majority of patients will have complete recovery over several months. We present a rare case of DRESS secondary to oxcarbazepine with an elevated human herpesvirus-6 titer.

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Section: Discussionmentioning

confidence: 99%

Drug Reaction with Eosinophilia and Systemic Symptoms: DRESS following Initiation of Oxcarbazepine with Elevated Human Herpesvirus-6 Titer

Cornell

DiBlasi

Arora

2014

Case Reports in Dermatological Medicine

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“…Drug reaction with eosinophilia and systemic symptoms (DRESS) was first identified in the 1920s as a severe drug reaction to an anti-epileptic medication, nirvanol [ 1 ]. Since that time, DRESS has become known as an idiosyncratic life-threatening reaction comprised of fevers, rash, and leukocytosis with eosinophilia.…”

Section: Introductionmentioning

confidence: 99%

Oxacillin-Induced Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS)

et al. 2019

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Patient: Male, 52Final Diagnosis: Drug reaction with eosinophilia and systemic symptomsSymptoms: RashMedication: OxacillinClinical Procedure: —Specialty: Critical Care MedicineObjective:Rare diseaseBackground:Drug reaction with eosinophilia and systemic symptoms (DRESS) is an idiosyncratic life-threatening reaction comprised of fevers, rash, and leukocytosis with eosinophilia. Though characteristically associated with leukocytosis, there are rare case reports of DRESS-induced agranulocytosis. DRESS is most frequently caused by antiepileptic medications; however, it has very rarely been reported in relation to oxacillin. We describe a case of oxacillin-induced DRESS associated with agranulocytosis.Case Report:A 52-year-old male was admitted for an epidural abscess secondary to oxacillin-sensitive Staphylococcus aureus, for which an extended course of oxacillin and rifampin was initiated. On day 22 of therapy, the patient developed a fever of 38.7°C (101.6°F) with rigors. His complete blood cell count revealed new leukopenia (1.8×103/uL) with 16% eosinophils and 3% atypical lymphocytes. Antibiotics were transitioned from oxacillin and rifampin to vancomycin, cefepime, and rifampin for presumed sepsis of unclear etiology. On day 23, he was noted to have a pruritic erythematous blanching papular rash on his chest, trunk, neck, and left upper extremity. Infectious workup was unrevealing, and his fever curve up-trended to 39.3°C (102.7°F) with no clinical improvement on broad-spectrum antimicrobials, suggestive of a non-infectious etiology of his rash and fevers. His rash evolved into confluent red patches, and eosinophilia rose to 21%, which was concerning for a drug reaction. His RegiSCAR score was calculated to be 6, consistent with definite DRESS. Leukopenia resolved (6.3×103/uL) 4 days after discontinuing oxacillin. His epidural abscess was ultimately treated with daptomycin, and DRESS was managed supportively with antihistamines and triamcinolone cream.Conclusions:We highlight this case because of the rarity of DRESS with agranulocytosis related to oxacillin. Beta-lactam antibiotics are widely used, and while DRESS is an uncommon condition, clinicians should consider this diagnosis when managing patients with fevers, leukopenia, and rash.

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