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BMJ Case Rep ; 20152015 Oct 05.
Article in English | MEDLINE | ID: mdl-26438676

ABSTRACT

Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome is characterised by fever, rash, eosinophilia and organ damage that develops 2-6 weeks after the initiation of a medication. We report a case of DRESS syndrome in a 79-year-old man that developed after the introduction of rifabutin, ethambutol and clarithromycin used to treat Mycobacterium avium complex (MAC) vertebral osteomyelitis. This case highlights treatment and management challenges in a patient with known MAC vertebral osteomyelitis requiring prolonged steroids. Steroids are the mainstays of treatment for moderate to severe cases of DRESS syndrome. Initiation of steroids for the treatment of DRESS syndrome among patients with concomitant infections requires multidisciplinary collaboration for optimal management.


Subject(s)
Anti-Bacterial Agents/adverse effects , Drug Hypersensitivity Syndrome/diagnosis , Mycobacterium avium Complex/drug effects , Mycobacterium avium-intracellulare Infection/drug therapy , Osteomyelitis/drug therapy , Prednisone/therapeutic use , Aged , Anti-Bacterial Agents/administration & dosage , Clarithromycin/administration & dosage , Clarithromycin/adverse effects , Drug Hypersensitivity Syndrome/drug therapy , Drug Hypersensitivity Syndrome/physiopathology , Ethambutol/administration & dosage , Ethambutol/adverse effects , Humans , Liver Function Tests , Male , Rifabutin/administration & dosage , Rifabutin/adverse effects , Treatment Outcome
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