Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome secondary to antimicrobial therapy in pediatric bone and joint infections
Background: Bone and joint infections are common in children, particularly those under 10 years of age. While antimicrobial therapy can often successfully treat these infections, surgical drainage may also be necessary. It is important to note that prolonged courses of treatment have been associated...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-02-01
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| Series: | World Allergy Organization Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1939455123001102 |
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| author | Sema Yildirim Arslan, MD Zumrut Sahbudak Bal, MD Gizem Guner Ozenen, MD Nimet Melis Bilen, MD Gulhadiye Avcu, MD Ece Erci, MD Zafer Kurugol, MD Huseyin Gunay, MD İpek Tamsel, MD Ferda Ozkinay, MD |
| author_facet | Sema Yildirim Arslan, MD Zumrut Sahbudak Bal, MD Gizem Guner Ozenen, MD Nimet Melis Bilen, MD Gulhadiye Avcu, MD Ece Erci, MD Zafer Kurugol, MD Huseyin Gunay, MD İpek Tamsel, MD Ferda Ozkinay, MD |
| author_sort | Sema Yildirim Arslan, MD |
| collection | DOAJ |
| description | Background: Bone and joint infections are common in children, particularly those under 10 years of age. While antimicrobial therapy can often successfully treat these infections, surgical drainage may also be necessary. It is important to note that prolonged courses of treatment have been associated with adverse events and drug reactions. Among these, drug reactions with eosinophilia and systemic symptoms (DRESS) syndrome is particularly severe and potentially life-threatening. We aimed to evaluate the cases of DRESS syndrome that develop during the treatment of bone and joint infections. Methods: A retrospective study was conducted at a tertiary-level university hospital between 2015 and 2022 to determine the incidence and outcomes of definite DRESS Syndrome in children under 18 years of age with bone and joint infections. Results: Of 73 patients with bone and joint infections, 16 (21.9 %) children developed antimicrobial therapy-induced DRESS syndrome. Eight (50 %) of these children were boys; the mean age of the patients was 9.76 ± 5.5 years. DRESS syndrome occurred in 16 children, including 13 children with osteomyelitis, 1 child with osteomyelitis and septic arthritis, and 2 children with septic arthritis and sacroiliitis. The mean duration of intravenous antibiotic therapy was 40.6 ± 16.6 days; the mean hospital stay was 48.7 ± 23.7 days; the mean time for the development of DRESS syndrome after starting antibiotics was 19.6 ± 7.68 days. New onset fever (68.8 %) and rash (43.8 %) were the most common symptoms of DRESS Syndrome. Cefotaxime and vancomycin were drugs responsible for DRESS syndrome in 8 (50 %) of 16. The causative antibiotics were switched to another class of antibiotic, most commonly preferred was ciprofloxacin (n:5; 31.3 %). For children with persistent symptoms, steroids were used in 5 (31.25) patients. Conclusions: Clinicians should be aware of DRESS syndrome in children who develop fever and rash under long-term antibiotics and should check hematological and biochemical parameters to predict the severity of DRESS syndrome. In patients with persistent symptoms, steroids may be used to control the symptoms. |
| first_indexed | 2024-03-08T04:50:51Z |
| format | Article |
| id | doaj.art-9bf7076bd60642deb4bf1a7e3ff47215 |
| institution | Directory Open Access Journal |
| issn | 1939-4551 |
| language | English |
| last_indexed | 2024-03-08T04:50:51Z |
| publishDate | 2024-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | World Allergy Organization Journal |
| spelling | doaj.art-9bf7076bd60642deb4bf1a7e3ff472152024-02-08T05:07:32ZengElsevierWorld Allergy Organization Journal1939-45512024-02-01172100850Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome secondary to antimicrobial therapy in pediatric bone and joint infectionsSema Yildirim Arslan, MD0Zumrut Sahbudak Bal, MD1Gizem Guner Ozenen, MD2Nimet Melis Bilen, MD3Gulhadiye Avcu, MD4Ece Erci, MD5Zafer Kurugol, MD6Huseyin Gunay, MD7İpek Tamsel, MD8Ferda Ozkinay, MD9Medical School of Ege University, Division of Infectious Disease, Department of Pediatrics, Izmir, TurkeyMedical School of Ege University, Division of Infectious Disease, Department of Pediatrics, Izmir, Turkey; Corresponding author. Medical School of Ege University, Division of Infectious Disease, Department of Pediatrics, Turkey.Medical School of Ege University, Division of Infectious Disease, Department of Pediatrics, Izmir, TurkeyMedical School of Ege University, Division of Infectious Disease, Department of Pediatrics, Izmir, TurkeyMedical School of Ege University, Division of Infectious Disease, Department of Pediatrics, Izmir, TurkeyMedical School of Ege University, Division of Infectious Disease, Department of Pediatrics, Izmir, TurkeyMedical School of Ege University, Division of Infectious Disease, Department of Pediatrics, Izmir, TurkeyMedical School of Ege University, Department of Orthopaedics and Traumatology, Izmir, TurkeyMedical School of Ege University, Department of Radiology, Izmir, TurkeyMedical School of Ege University, Division of Infectious Disease, Department of Pediatrics, Izmir, TurkeyBackground: Bone and joint infections are common in children, particularly those under 10 years of age. While antimicrobial therapy can often successfully treat these infections, surgical drainage may also be necessary. It is important to note that prolonged courses of treatment have been associated with adverse events and drug reactions. Among these, drug reactions with eosinophilia and systemic symptoms (DRESS) syndrome is particularly severe and potentially life-threatening. We aimed to evaluate the cases of DRESS syndrome that develop during the treatment of bone and joint infections. Methods: A retrospective study was conducted at a tertiary-level university hospital between 2015 and 2022 to determine the incidence and outcomes of definite DRESS Syndrome in children under 18 years of age with bone and joint infections. Results: Of 73 patients with bone and joint infections, 16 (21.9 %) children developed antimicrobial therapy-induced DRESS syndrome. Eight (50 %) of these children were boys; the mean age of the patients was 9.76 ± 5.5 years. DRESS syndrome occurred in 16 children, including 13 children with osteomyelitis, 1 child with osteomyelitis and septic arthritis, and 2 children with septic arthritis and sacroiliitis. The mean duration of intravenous antibiotic therapy was 40.6 ± 16.6 days; the mean hospital stay was 48.7 ± 23.7 days; the mean time for the development of DRESS syndrome after starting antibiotics was 19.6 ± 7.68 days. New onset fever (68.8 %) and rash (43.8 %) were the most common symptoms of DRESS Syndrome. Cefotaxime and vancomycin were drugs responsible for DRESS syndrome in 8 (50 %) of 16. The causative antibiotics were switched to another class of antibiotic, most commonly preferred was ciprofloxacin (n:5; 31.3 %). For children with persistent symptoms, steroids were used in 5 (31.25) patients. Conclusions: Clinicians should be aware of DRESS syndrome in children who develop fever and rash under long-term antibiotics and should check hematological and biochemical parameters to predict the severity of DRESS syndrome. In patients with persistent symptoms, steroids may be used to control the symptoms.http://www.sciencedirect.com/science/article/pii/S1939455123001102Bone and joint infectionDRESS syndromeChildren |
| spellingShingle | Sema Yildirim Arslan, MD Zumrut Sahbudak Bal, MD Gizem Guner Ozenen, MD Nimet Melis Bilen, MD Gulhadiye Avcu, MD Ece Erci, MD Zafer Kurugol, MD Huseyin Gunay, MD İpek Tamsel, MD Ferda Ozkinay, MD Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome secondary to antimicrobial therapy in pediatric bone and joint infections World Allergy Organization Journal Bone and joint infection DRESS syndrome Children |
| title | Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome secondary to antimicrobial therapy in pediatric bone and joint infections |
| title_full | Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome secondary to antimicrobial therapy in pediatric bone and joint infections |
| title_fullStr | Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome secondary to antimicrobial therapy in pediatric bone and joint infections |
| title_full_unstemmed | Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome secondary to antimicrobial therapy in pediatric bone and joint infections |
| title_short | Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome secondary to antimicrobial therapy in pediatric bone and joint infections |
| title_sort | drug reaction with eosinophilia and systemic symptoms dress syndrome secondary to antimicrobial therapy in pediatric bone and joint infections |
| topic | Bone and joint infection DRESS syndrome Children |
| url | http://www.sciencedirect.com/science/article/pii/S1939455123001102 |
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