Drug Rash With Eosinophilia and Systemic Symptoms (DRESS) Syndrome Due to Vancomycin

Kulkarni, Mugdha P; Chinta, Siddharth; Sosa, Franklin; Nasr, Rabih; Kelly, Paul A.

doi:10.7759/cureus.26219

Cited by 5 publications

(14 citation statements)

References 11 publications

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“…Table 3 and Table 4 present a summary and analysis of 44 cases of eosinophilia caused by vancomycin. 2–8,35–65 Of these 44 cases, drug reaction with eosinophilia and systemic symptoms (DRESS), also known as drug-induced hypersensitivity syndrome, was found in 35 cases. 2–8,35–57 In other cases, some patients had increased eosinophil counts an...…”

Section: Discussionmentioning

confidence: 99%

“…2–8,35–65 Of these 44 cases, drug reaction with eosinophilia and systemic symptoms (DRESS), also known as drug-induced hypersensitivity syndrome, was found in 35 cases. 2–8,35–57 In other cases, some patients had increased eosinophil counts and involvement of other organs such as kidney, lung and heart function due to intravenous use of vancomycin. 58,…”

Section: Discussionmentioning

confidence: 99%

“…58,62,63 Although the reported cases were been clearly diagnosed as DRESS, they were considered to have this syndrome based on the case data. A comprehensive review all of the 44 published cases with eosinophilia caused by vancomycin demonstrated the following (Table 4): 2–8,35–65 male patients were more often affected (27 of 44 patients; 61.4%); the median age was 46.8 years (range, 2 months to 59 years); the median time to vancomycin-related symptoms was 23.5 days (range, 3–49 days); and the median eosinophil count was 5.22 × 10 9 /l (range, 0.85–37.5 × 10 9 /l). Fever (32 of 44 patients; 72.7%) and/or rash (36 of 44 patients; 81.8%) were the first symptoms of eosinophilia in patients with vancomycin treatment; and another two cases had hypotension or were asymptomatic after intraperitoneal injection of vancomycin.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical characteristics of eosinophilia caused by vancomycin reported in 44 cases in the published literature [2][3][4][5][6][7][8]. …”

mentioning

confidence: 99%

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A rare case of infant eosinophilia induced by oral vancomycin: a case report and literature review

Yin

Guo

et al. 2023

J Int Med Res

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Oral vancomycin is mainly used to treat and prevent active Clostridium difficile infection. Because it is widely believed that there is a very low absorption rate via the gastrointestinal tract, reports of adverse reactions following oral vancomycin administration are rare. This case report describes for the first time a case of antibiotic-associated diarrhoea in a 2-month-old infant treated with oral vancomycin. After oral vancomycin treatment, the number of eosinophils increased significantly and the levels gradually recovered after drug withdrawal. A review and analysis of the previously reported adverse reactions caused by oral vancomycin and eosinophilia caused by vancomycin confirm the need for physicians to pay close attention to vancomycin-related adverse reactions, to monitor the required concentration and to measure eosinophil counts in patients with rash-related adverse reactions. Patients with concomitant diseases and children should be monitored for adverse events as it is possible that they have increased gastrointestinal absorption of vancomycin following oral administration. When vancomycin causes eosinophilia, fever and rash, physicians should be alert to the possibility of organ damage.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Clinical characteristics of eosinophilia caused by vancomycin reported in 44 cases in the published literature [2][3][4][5][6][7][8]. …”

mentioning

confidence: 99%

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A rare case of infant eosinophilia induced by oral vancomycin: a case report and literature review

Yin

Guo

et al. 2023

J Int Med Res

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“…The incidence of DRESS is estimated to be one in every 1000-10000 exposures [ 9 , 10 ]. DRESS reaction is suggested to be mediated by T-cell hypersensitivity [ 11 ]. Antibiotics attribute to 74% of DRESS cases, and sulfonamides compromised 3% of the cases [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Trimethoprim-Sulfamethoxazole-Induced Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Complicated by Acute Liver Failure

Hindosh¹,

Kotala²,

Nguyen³

et al. 2022

Cureus

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Drug reaction with eosinophilia and systemic symptoms (DRESS) is a delayed adverse drug reaction that is characterized by fever, cutaneous manifestation, enlarged lymph nodes, hematologic abnormalities, and organ involvement. Multiple medications have been reported to cause DRESS with the presentation varying from drug to drug. Some cases are mild and can be managed by stopping the causative agent along with supportive measures; however, other cases can lead to multi-organ failure requiring systemic corticosteroids and organ transplant. Acute liver failure is a rare manifestation of DRESS. We report a patient who had recently completed a course of trimethoprim-sulfamethoxazole and presented with low-grade fever, diffuse skin rash, eosinophilia, elevated liver enzymes, acute kidney injury, and thrombocytopenia. DRESS was subsequently diagnosed based on history, physical examination, and relatively negative workup for an alternate diagnosis. The patient eventually showed improvement with steroid therapy without the need for a liver transplant. Due to its pharmacogenetic susceptibility, it is essential to recommend avoiding the causative medication for the patient's family members.

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Exploring recent advances in drugs severe cutaneous adverse reactions immunopathology

Cadot,

Gery,

Lenief

et al. 2024

Allergy

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Severe cutaneous adverse reactions to drugs (SCARs) are rare but life‐threatening delayed allergies. While they primarily affect the skin, they can also affect internal organs. Accordingly, they present with diverse clinical symptoms that vary not only between SCARs subtypes but also among patients. Despite the availability of topical and systemic treatments, these only address the symptoms and not the cause. To develop more effective therapies, it is necessary to elucidate the complexity of the pathophysiology of SCARs in relation to their severity. In line with the new type IV hypersensitivity reactions nomenclature proposed by the European Academy of Allergy and Clinical Immunology (EAACI), this review highlights the current insights into the intricate immune mechanisms engaged, the interplay between the culprit drug and genetic predisposition in drug presentation mechanisms, but also how external factors, such as viruses, are implicated in SCARs. Their relevance to the development of targeted medicine is also discussed.

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Drug Rash With Eosinophilia and Systemic Symptoms (DRESS) Syndrome Due to Vancomycin

Cited by 5 publications

References 11 publications

A rare case of infant eosinophilia induced by oral vancomycin: a case report and literature review

A rare case of infant eosinophilia induced by oral vancomycin: a case report and literature review

Trimethoprim-Sulfamethoxazole-Induced Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Complicated by Acute Liver Failure

Exploring recent advances in drugs severe cutaneous adverse reactions immunopathology

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