DRESS syndrome with hepatic involvement in a patient with depressive disorder

We present a 31-year-old woman with a depressive disorder admitted in the Infectious Diseases Department with high fever, cervical lymphadenopathy, generalized rash and progressive jaundice. Sepsis with hepatic involvement was initially suspected, but the bacteriological and serological profiles for viral and bacterial pathogens remained negative. The exposure to antidepressant medication including lamotrigine, an aromatic anticonvulsant molecule, raised the suspicion of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome. The antidepressants were withdrawn and methylprednisolone therapy was started with a favorable outcome and lent recovery after two months. This case highlights a rare drug allergic complication to antidepressant medication evolving as a sepsis with hepatic dysfunction.