Minocycline as possible cause of severe and protracted hypersensitivity drug reaction

Minocycline-induced drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome with persistent myocarditis

“…14 Hypersensitivity myocarditis is a rare manifestation of minocycline-induced DRESS syndrome, which more commonly displays liver or kidney involvement. 6 To date, only two cases of minocycline-induced hypersensitivity myocarditis have been reported. 6,8 Hypersensitivity myocarditis typically presents as myocardial dysfunction, cardiomegaly, ST-T electrocardiogram abnormalities, or conduction defects.…”

“…6 To date, only two cases of minocycline-induced hypersensitivity myocarditis have been reported. 6,8 Hypersensitivity myocarditis typically presents as myocardial dysfunction, cardiomegaly, ST-T electrocardiogram abnormalities, or conduction defects. Some patients may have eosinophilia or mildly elevated cardiac enzymes.…”

“…This finding suggests the possibility of viral triggering in hypersensitivity myocarditis. 6 The possibility of viral activation of DRESS syndrome has been explored in the context of human herpesvirus 6 (HHV-6) infection and reactivation. 15 Hypersensitivity reaction to various drugs can be induced in patients who develop active HHV-6 infection even if the drug was previously tolerated.…”

A review of DRESS-associated myocarditis

“…[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Articles were gathered primarily from MEDLINE and then from the bibliographies of acquired reports of DRESS/DIHS (drug-induced hypersensitivity syndrome). The patients exhibited symptoms of hypersensitivity myocarditis and/or ANEM, as defined by the criteria of Bocquet, Bagot, and Roujeau.…”

Systemic Antibiotics for Acne

“…Different side effects are specifically provoked by minocycline: the well-known vertigo of which the incidence – higher in women than in men, i.e. 70 versus 28% – has limited the use of the drug [53]; fever alone [54] or with exanthema, lymphadenopathy, hepatitis and profound leukemoid reaction [27] or with Sweet’s syndrome [55, 56], diffuse pustular eruption and enlarged lymph nodes [57] or with pulmonary infiltrates and eosinophilia with dyspnea and generally fever [58, 59, 60, 61, 62]; serum sickness characterized by rash and arthralgias [63]. …”