Delayed aminopenicillin reaction associated to human herpes virus 6 infection mimicking DRESS syndrome
Background: DRESS syndrome (rash with eosinophilia and systemic symptoms) is an uncommon and severe drug-induced reaction. Clinical case: An 8-year-old boy was diagnosed with tonsillopharyngitis, and treatment with amoxicillin was started. One day later, he presented bilateral malar rash which evol...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Colegio Mexicano de Inmunología Clínica y Alergia, A.C.
2019-06-01
|
| Series: | Revista Alergia México |
| Subjects: | |
| Online Access: | http://revistaalergia.mx/ojs/index.php/ram/article/view/540 |
| _version_ | 1827885002001481728 |
|---|---|
| author | Laura Míguez-Martín Helena Higelmo-Gómez Ángela Gómez-Farpón Francisco Álvarez-Caro |
| author_facet | Laura Míguez-Martín Helena Higelmo-Gómez Ángela Gómez-Farpón Francisco Álvarez-Caro |
| author_sort | Laura Míguez-Martín |
| collection | DOAJ |
| description | Background: DRESS syndrome (rash with eosinophilia and systemic symptoms) is an uncommon and severe drug-induced reaction.
Clinical case: An 8-year-old boy was diagnosed with tonsillopharyngitis, and treatment with amoxicillin was started. One day later, he presented bilateral malar rash which evolved to generalized erythroderma in two days. He was referred to the emergency room and then he was discharged after the treatment with amoxicillin was discontinued. Five days later, he still had fever, progressive facial and acral edema, and ecchymotic lesions. The laboratory studies showed 6220 leukocytes/mm3 (970 eosinophils/mm3). The pharyngeal culture tested positive to human herpesvirus 6 (HHV-6). The fever, rash and edema disappeared with supportive measures. Based on the results of the allergy tests, a diagnosis of delayed reaction to aminopenicillin associated to HHV-6 mimicking DRESS syndrome was made, with the recommendation to avoid penicillin antibiotics.
Conclusions: The diagnosis of delayed reactions to aminopenicillin and DRESS syndrome requires a high index of suspicion in order to promptly withdraw the offending medication and to avoid delays in the diagnosis. |
| first_indexed | 2024-03-12T19:37:59Z |
| format | Article |
| id | doaj.art-f9870fbc487d4c6bb3aa65589e2d20ef |
| institution | Directory Open Access Journal |
| issn | 0002-5151 2448-9190 |
| language | English |
| last_indexed | 2024-03-12T19:37:59Z |
| publishDate | 2019-06-01 |
| publisher | Colegio Mexicano de Inmunología Clínica y Alergia, A.C. |
| record_format | Article |
| series | Revista Alergia México |
| spelling | doaj.art-f9870fbc487d4c6bb3aa65589e2d20ef2023-08-02T04:04:56ZengColegio Mexicano de Inmunología Clínica y Alergia, A.C.Revista Alergia México0002-51512448-91902019-06-0166337537810.29262/ram.v66i3.540431Delayed aminopenicillin reaction associated to human herpes virus 6 infection mimicking DRESS syndromeLaura Míguez-Martín0Helena Higelmo-Gómez1Ángela Gómez-Farpón2Francisco Álvarez-Caro3Hospital Universitario de Cabueñes, Servicio de Pediatría, GijónHospital Universitario de Cabueñes, Servicio de Pediatría, GijónHospital Central de Asturias, Área de Gestión Clínica de Pediatría, OviedoHospital Central de Asturias, Área de Gestión Clínica de Pediatría, OviedoBackground: DRESS syndrome (rash with eosinophilia and systemic symptoms) is an uncommon and severe drug-induced reaction. Clinical case: An 8-year-old boy was diagnosed with tonsillopharyngitis, and treatment with amoxicillin was started. One day later, he presented bilateral malar rash which evolved to generalized erythroderma in two days. He was referred to the emergency room and then he was discharged after the treatment with amoxicillin was discontinued. Five days later, he still had fever, progressive facial and acral edema, and ecchymotic lesions. The laboratory studies showed 6220 leukocytes/mm3 (970 eosinophils/mm3). The pharyngeal culture tested positive to human herpesvirus 6 (HHV-6). The fever, rash and edema disappeared with supportive measures. Based on the results of the allergy tests, a diagnosis of delayed reaction to aminopenicillin associated to HHV-6 mimicking DRESS syndrome was made, with the recommendation to avoid penicillin antibiotics. Conclusions: The diagnosis of delayed reactions to aminopenicillin and DRESS syndrome requires a high index of suspicion in order to promptly withdraw the offending medication and to avoid delays in the diagnosis.http://revistaalergia.mx/ojs/index.php/ram/article/view/540dress syndromeamoxicillinhuman herpesvirus 6eosinophilia |
| spellingShingle | Laura Míguez-Martín Helena Higelmo-Gómez Ángela Gómez-Farpón Francisco Álvarez-Caro Delayed aminopenicillin reaction associated to human herpes virus 6 infection mimicking DRESS syndrome Revista Alergia México dress syndrome amoxicillin human herpesvirus 6 eosinophilia |
| title | Delayed aminopenicillin reaction associated to human herpes virus 6 infection mimicking DRESS syndrome |
| title_full | Delayed aminopenicillin reaction associated to human herpes virus 6 infection mimicking DRESS syndrome |
| title_fullStr | Delayed aminopenicillin reaction associated to human herpes virus 6 infection mimicking DRESS syndrome |
| title_full_unstemmed | Delayed aminopenicillin reaction associated to human herpes virus 6 infection mimicking DRESS syndrome |
| title_short | Delayed aminopenicillin reaction associated to human herpes virus 6 infection mimicking DRESS syndrome |
| title_sort | delayed aminopenicillin reaction associated to human herpes virus 6 infection mimicking dress syndrome |
| topic | dress syndrome amoxicillin human herpesvirus 6 eosinophilia |
| url | http://revistaalergia.mx/ojs/index.php/ram/article/view/540 |
| work_keys_str_mv | AT lauramiguezmartin delayedaminopenicillinreactionassociatedtohumanherpesvirus6infectionmimickingdresssyndrome AT helenahigelmogomez delayedaminopenicillinreactionassociatedtohumanherpesvirus6infectionmimickingdresssyndrome AT angelagomezfarpon delayedaminopenicillinreactionassociatedtohumanherpesvirus6infectionmimickingdresssyndrome AT franciscoalvarezcaro delayedaminopenicillinreactionassociatedtohumanherpesvirus6infectionmimickingdresssyndrome |