Differential Diagnosis of Fever of Unknown Origin in Drug Reaction with Eosinophilia and Systemic Symptom (DRESS)
Objective: To describe an unusual case of drug reaction with eosinophilia and systemic symptoms presenting as fever of unknown origin (FUO) and the diagnostic hurdles that come with the presence of differential diagnosis of FUO, which is tuberculous lymphadenitis. Methods: A 34-year-old female with...
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| Format: | Article |
| Language: | English |
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Universitas Padjadjaran
2022-04-01
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| Series: | International Journal of Integrated Health Sciences |
| Subjects: | |
| Online Access: | http://journal.fk.unpad.ac.id/index.php/ijihs/article/view/2198 |
| _version_ | 1818469548508053504 |
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| author | Kevin Fachri Muhammad Ferdy Ferdian Andri Reza Rahmadi |
| author_facet | Kevin Fachri Muhammad Ferdy Ferdian Andri Reza Rahmadi |
| author_sort | Kevin Fachri Muhammad |
| collection | DOAJ |
| description | Objective: To describe an unusual case of drug reaction with eosinophilia and systemic symptoms presenting as fever of unknown origin (FUO) and the diagnostic hurdles that come with the presence of differential diagnosis of FUO, which is tuberculous lymphadenitis.
Methods: A 34-year-old female with a chief complaint of fever that has lasted for 3 weeks accompanied with jaundice and skin rashes for 2 weeks was admitted with an indication of FUO. She had a history of carbamazepine consumption for trigerminal neuralgia 2 months prior. Cervical lymphadenopathy was palpable bilaterally and hepatomegaly, elevated liver enzyme, as well as hyperbilirubinemia were observed. After excluding differentials for many causes of prolonged fever, patient was treated for Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) and was given intravenous steroid injections. Fine needle aspiration biopsy was performed for her cervical lymphadenopathy.
Results: Biopsy presented a mix of sialadenitis and tuberculous lymphadenopathy. Clinical improvement was observed on the second day after steroid administration. Patient was discharged on the seventh day after steroid administration.
Conclusion: FUO is one of the possible manifestations of DRESS; however, thorough investigation still needed to be done considering the possibility of more than one entity of disease that can cause FUO in patients, such as tuberculous lymphadenopathy seen in this case. |
| first_indexed | 2024-04-13T21:25:00Z |
| format | Article |
| id | doaj.art-55555a1417314cceb45698b9a4bf26dd |
| institution | Directory Open Access Journal |
| issn | 2302-1381 2338-4506 |
| language | English |
| last_indexed | 2024-04-13T21:25:00Z |
| publishDate | 2022-04-01 |
| publisher | Universitas Padjadjaran |
| record_format | Article |
| series | International Journal of Integrated Health Sciences |
| spelling | doaj.art-55555a1417314cceb45698b9a4bf26dd2022-12-22T02:29:21ZengUniversitas PadjadjaranInternational Journal of Integrated Health Sciences2302-13812338-45062022-04-01101394510.15850/ijihs.v10n1.21981443Differential Diagnosis of Fever of Unknown Origin in Drug Reaction with Eosinophilia and Systemic Symptom (DRESS)Kevin Fachri Muhammad0Ferdy Ferdian1Andri Reza Rahmadi2Department of Internal Medicine, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, BandungDepartment of Pulmonology, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, BandungDepartment of Internal Medicine, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, BandungObjective: To describe an unusual case of drug reaction with eosinophilia and systemic symptoms presenting as fever of unknown origin (FUO) and the diagnostic hurdles that come with the presence of differential diagnosis of FUO, which is tuberculous lymphadenitis. Methods: A 34-year-old female with a chief complaint of fever that has lasted for 3 weeks accompanied with jaundice and skin rashes for 2 weeks was admitted with an indication of FUO. She had a history of carbamazepine consumption for trigerminal neuralgia 2 months prior. Cervical lymphadenopathy was palpable bilaterally and hepatomegaly, elevated liver enzyme, as well as hyperbilirubinemia were observed. After excluding differentials for many causes of prolonged fever, patient was treated for Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) and was given intravenous steroid injections. Fine needle aspiration biopsy was performed for her cervical lymphadenopathy. Results: Biopsy presented a mix of sialadenitis and tuberculous lymphadenopathy. Clinical improvement was observed on the second day after steroid administration. Patient was discharged on the seventh day after steroid administration. Conclusion: FUO is one of the possible manifestations of DRESS; however, thorough investigation still needed to be done considering the possibility of more than one entity of disease that can cause FUO in patients, such as tuberculous lymphadenopathy seen in this case.http://journal.fk.unpad.ac.id/index.php/ijihs/article/view/2198case reportdressdrug reactionfever of unknown origintreatment |
| spellingShingle | Kevin Fachri Muhammad Ferdy Ferdian Andri Reza Rahmadi Differential Diagnosis of Fever of Unknown Origin in Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) International Journal of Integrated Health Sciences case report dress drug reaction fever of unknown origin treatment |
| title | Differential Diagnosis of Fever of Unknown Origin in Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) |
| title_full | Differential Diagnosis of Fever of Unknown Origin in Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) |
| title_fullStr | Differential Diagnosis of Fever of Unknown Origin in Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) |
| title_full_unstemmed | Differential Diagnosis of Fever of Unknown Origin in Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) |
| title_short | Differential Diagnosis of Fever of Unknown Origin in Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) |
| title_sort | differential diagnosis of fever of unknown origin in drug reaction with eosinophilia and systemic symptom dress |
| topic | case report dress drug reaction fever of unknown origin treatment |
| url | http://journal.fk.unpad.ac.id/index.php/ijihs/article/view/2198 |
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