ABSTRACT
Drug Rash with Eosinophilia and Systemic Symptoms [DRESS] syndrome reflects a serious hypersensitivity reaction to drugs. This syndrome is an uncommon adverse reaction due to antituberculosis drugs and is sometimes difficult to identify the culprit agent. We report a case of a 45-year-old woman who received combined antituberculosis drugs [RHZE] for lymph node tuberculosis. Clinical manifestations included fever, dyspnea, rash, hypereosinophilia and visceral involvement [liver involvment]. After symptom resolution and biology normalization, anti-tuberculosis drugs were reintroduced successively one after another. Systemic symptoms reappeared with the four anti-tuberculosis drugs. The clinical outcome was favorable with second line antituberculosis treatment
ABSTRACT
Influenza A [H1N1] is a contagious acute respiratory infection caused by a subtype influenza virus A [H1N1]. The later had caused a pandemic in 2009. Despite its low mortality, the disease was more severe in some subgroups. Describe confirmed cases of influenza A [H1N1] addressed to the pulmonary department of the Rabta hospital and identify risk factors. During the pandemic influenza A [H1N1], pulmonary department of Rabta hospital was identified among the centers to receive and detect new cases in addition to hospitalization of severe ones. All subjects had nasal and pharyngeal swabs. The authors distinguished non-severe and severe cases; hospitalization was indicated for severe forms. From September 2009 to March 2010, influenza A [H1N1] has been confirmed in 189 patients. The average age was 27.3 years [2-72 years]. Sex ratio was 1.2. Contagion was found in all patients. Twenty-two patients were hospitalized for the severe form. Mean age was 56 years, sex ratio was 0.47. Among them, 20 patients had at least one co-morbidity. Most frequently found risk factors were diabetes [9 cases], chronic respiratory disease [9 cases] and pregnancy [6 cases]. All patients received ozeltamivir. The dose was doubled in severe cases. Nonspecific antibiotic therapy was prescribed in 11 cases. Seven patients were hospitalized in intensive care unit, among whom 4 died. Mortality in severe forms was 18% and overall mortality 2.1%. Through this Tunisian series, we emphasize the potential severity of influenza A [H1N1]. This justifies a systematic vaccination of subjects at risk even away from pandemic period