Drug reaction with eosinophilia and systemic symptoms (DRESS) and multiple organ dysfunction syndrome (MODS): one more reason for a new effective treatment against leishmaniasis

Int J Dermatol. 2018 Nov;57(11):1304-1313. doi: 10.1111/ijd.14126. Epub 2018 Aug 29.

Abstract

Introduction: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe drug-induced reaction associated with eosinophilia and systemic manifestations. Anticonvulsants, sulfonamides, and antivirals are the most related and described drugs in DRESS syndrome.

Methods and case: We present a case of severe multiple organ dysfunction syndrome (MODS) with the risk of death associated with DRESS syndrome due to antileishmanial pentavalent antimonial drug and its simultaneous toxicity. Consequently, a comprehensive review of the main clinical problems and comparative discussion of both clinical conditions was made.

Discussion: The overlap of DRESS syndrome and antileishmanial pentavalent antimonial drug toxicity can be life-threatening. Both conditions represent a true clinical, diagnostic, and therapeutic challenge. We exposed specific clinical and laboratory results with rare occurrence.

Conclusion: Any physician and dermatologists should keep in mind the broad spectrum of clinical manifestations and laboratory findings associated with the use of pentavalent antimonial drugs. The clinical suspicion, an early diagnosis, and aggressive treatment are essential to prevent complications and death.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antiprotozoal Agents / adverse effects*
  • Drug Hypersensitivity Syndrome / etiology*
  • Humans
  • Leishmaniasis, Cutaneous / drug therapy*
  • Male
  • Meglumine Antimoniate / adverse effects*
  • Middle Aged
  • Multiple Organ Failure / etiology*

Substances

  • Antiprotozoal Agents
  • Meglumine Antimoniate