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A 53-year-old patient developed Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome, mimicking abdominal sepsis. Prompt diagnosis and treatment with steroids led to gradual improvement, highlighting DRESS syndrome as a rare differential diagnosis.

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Area of Science:

  • Internal Medicine
  • Clinical Pharmacology
  • Toxicology

Background:

  • Presents a rare case of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome.
  • Highlights the diagnostic challenge in differentiating DRESS syndrome from abdominal sepsis.
  • Emphasizes the potential for severe systemic manifestations, including hepatopathy and sepsis-like symptoms.

Purpose of the Study:

  • To illustrate the diagnostic pathway for a patient presenting with DRESS syndrome.
  • To underscore the importance of considering rare drug-induced conditions in patients with severe systemic symptoms.
  • To demonstrate the therapeutic efficacy of steroid administration in managing DRESS syndrome.

Main Methods:

  • Case report detailing the clinical presentation, diagnostic workup, and treatment of a 53-year-old patient.
  • Review of diagnostic criteria for DRESS syndrome and abdominal sepsis.
  • Monitoring of patient's response to discontinuation of antibiotic therapy and initiation of corticosteroids.

Main Results:

  • The patient initially presented with symptoms suggestive of abdominal sepsis, requiring vasoactive agents.
  • Diagnosis of DRESS syndrome was established after ruling out common causes of sepsis.
  • Significant clinical improvement was observed following cessation of antibiotic treatment and commencement of steroid therapy.

Conclusions:

  • DRESS syndrome can present with symptoms mimicking severe infections like abdominal sepsis.
  • Early recognition and withdrawal of the offending drug, coupled with appropriate management (e.g., steroids), are crucial for favorable outcomes.
  • This case underscores the importance of a broad differential diagnosis in complex clinical scenarios.