Is a Drug Alone Sufficient to Cause the Drug Hypersensitivity Syndrome?

Carbamazepine-Induced Hypersensitivity Syndrome Occurring in a Photodistributed Pattern

“…Other studies and case reports of DIHS have also been linked with the reactivation or infection of viruses such as human herpesvirus 6 and 7, cytomegalovirus, Epstein-Barr virus and herpes simplex viruses [8,10,11,12]. However, the exact role of human herpesviruses in the pathogenesis of DIHS remains to be elucidated [12].…”

Glucocorticoids for Treatment of Severe Pediatric Drug Hypersensitivity Syndrome

“…22,23 However, HHV-6 infection is nearly ubiquitous in humans after infancy, 24,25 and evidence for its reactivation has been observed in a variety of conditions associated with altered immune regulation including common febrile illnesses of infancy and childhood. 26,27 There are no case controlled studies examining the prevalence of HHV-6 activation in patients with DHS as compared to in other forms of systemic illness. Thus, at present it is unclear whether HHV-6 represents a cofactor in the pathogenesis of DHS, or rather a non-specific consequence of generalized immune activation.…”

Herpesviruses in Patients with Drug Hypersensitivity Syndrome: Culprits, Cofactors or Innocent Bystanders?

“…The association of viral infections and adverse drug reactions is illustrated by 2 well-known examples: the high incidence of skin eruptions in EBV-infected patients who are given ampicillin and the significantly increased risk of cutaneous adverse drug reactions in HIV-infected patients [20] .…”