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[DRESS syndrome secondary to pyrazinamide: An uncommon complication of tuberculosis treatment]
U D Kombila1, W Ka2, F B R Mbaye2
1Service de médecine interne, centre hospitalier universitaire de Libreville (CHUL), BP 9264, Libreville, Gabon; Clinique de pneumologie, centre hospitalier national universitaire de FANN (CHNUF), avenue Cheikh-ANTA-DIOP, BP 5035, Dakar, Sénégal.
Introduction:
The Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) is a severe drug-induced reaction.
Case Report:
We report the case of a 35-year-old man treated by RHEZ for a first episode of a smear positive pulmonary tuberculosis and who developed a DRESS syndrome due to pyrazinamide after twenty days of treatment, associated with a viral reactivation to Human Herpes Virus 6 (HHV6). He had a skin eruption, liver involvement and hypereosinophilia. He fully recovered after drug withdrawal, associated with local and general corticosteroids. He died two weeks after discharge.
Conclusions:
Discovery of DRESS syndrome during tuberculosis treatment is an uncommon complication and requires a searching for the responsible drug. That should be difficult because tuberculosis drugs are often given as fixed-dose combination. Physicians have to bear in mind the potential role of pyrazinamide.
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