Drug Rash With Eosinophilia and Systemic Symptoms Syndrome in Infancy: A Report of Two Rare Cases

Abstract

Introduction: Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a severe form of adverse drug reaction which describes a potentially life threatening condition, associated with a high mortality rate. This syndrome is rarely seen in childhood even though a large number of children receive anticonvulsant treatment. Case Presentation: We report here two infants under two months of age, whose findings were consistent with DRESS syndrome due to phenobarbital usage. Considering their age, these two cases appeared to be unique to our knowledge. Good responses were observed in both cases after stopping the culprit drug and administration of systemic corticosteroid. Discussion: Early recognition of DRESS syndrome is of a particular importance. Although rare, in newborn infants with the presence of skin rash, liver involvement, hyper-eosinophilia and lymphadenopathy, DRESS diagnosis should be highly suspected and prompt intervention including withdrawal of causative drug is required to prevent potentially fatal outcomes.