Two cases of overlap severe cutaneous adverse reactions to benznidazole treatment for asymptomatic Chagas disease in a nonendemic country

Br J Dermatol. 2016 Sep;175(3):604-7. doi: 10.1111/bjd.14451. Epub 2016 Apr 7.

Abstract

Chagas disease is a parasitosis endemic to South America. It is normally treated with benznidazole as first choice, which has been associated with numerous cutaneous reactions. However, very few benznidazole-associated severe cutaneous adverse reactions have been reported to date. The rise of Chagas disease in nonendemic countries represents a growing public health challenge. We report two patients who met the criteria for drug reaction with eosinophilia and systemic symptoms syndrome and Stevens-Johnson syndrome/toxic epidermal necrolysis according to the RegiSCAR scoring systems. They were thus deemed overlapping cases, with a lymphocyte transformation test positive for benznidazole. Both required intensive care unit admission and both survived. Considering the rising application of this drug for trypanosomiasis in immigrant populations, clinicians should be aware of this newly reported, potentially life-threatening risk.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Chagas Disease / drug therapy*
  • Dermatitis, Exfoliative / chemically induced
  • Drug Eruptions / etiology*
  • Edema / chemically induced
  • Female
  • Humans
  • Male
  • Nitroimidazoles / adverse effects*
  • Stevens-Johnson Syndrome / diagnosis
  • Stevens-Johnson Syndrome / etiology*
  • Trypanocidal Agents / adverse effects*

Substances

  • Nitroimidazoles
  • Trypanocidal Agents
  • benzonidazole