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 unknown origin (FUO) the diagnostic hurdles that come presence differential diagnosis FUO, which is tuberculous lymphadenitis. Methods: A 34-year-old female a chief complaint has lasted for 3 weeks accompanied jaundice skin rashes 2 was admitted indication FUO. She had history carbamazepine consumption trigerminal neuralgia months prior. Cervical lymphadenopathy palpable bilaterally hepatomegaly, elevated liver enzyme, well hyperbilirubinemia were observed. After excluding differentials many causes prolonged fever, patient treated Drug Reaction Eosinophilia Systemic Symptom (DRESS) given intravenous steroid injections. Fine needle aspiration biopsy performed her cervical lymphadenopathy. Results: Biopsy presented mix sialadenitis Clinical improvement observed on second day after administration. Patient discharged seventh Conclusion: FUO one possible manifestations DRESS; however, thorough investigation still needed to be done considering possibility more than entity disease can cause in patients, such seen this case.