The Importance of Early Recognition: a Case of DRESS Syndrome

This case examines the presentation, diagnosis, and treatment of an otherwise healthy 22-year-old female who presented to urgent care with abdominal pain fever 27 days after her first exposure trimethoprim/sulfamethoxazole (TMP/SMX). However, this was not recognized for extended amount time. She initially diagnosed gastroenteritis sent home on metronidazole. failed improve later primary physician’s office where she treated levofloxacin a suspected urinary tract infection. Her clinical syndrome continued progress developed widespread rash generalized edema. admitted hospital outpatient laboratory analysis suggestive liver kidney damage. Drug Reaction Eosinophilia Systemic Symptoms (DRESS syndrome) in setting fever, rash, elevated enzymes, peripheral eosinophilia, dermatopathological findings. DRESS is diagnosis exclusion requires high level suspicion. The confirmed review history revealed received two courses TMP/SMX nearly four weeks prior.