Phenytoin Induced Drug Rash with Eosinophilia and Systemic Symptoms: A rare paediatric case report

Abstract

Purpose: Dress Syndrome (Drug rash with eosinophilia and systemic symptoms) is a severe adverse drug reaction characterised by rash, fever, lymphadenopathy, and organ involvement. It is a severe, one-of-a-kind adverse medication reaction. DRESS is the most rarely seen severe adverse drug reaction, and it affects approximately 1 in a thousand to 1 in a ten thousand patients who take the drug. It is found that the mortality rate is nearly 10 %. The main objectives include - learn the importance of DRESS syndrome, recognize the signs and symptoms of DRESS, to know what diagnostic studies are indicated and to provide accurate treatment.
 Methods: The case of 11-year-old girl who came with history of head injury and was given phenytoin to treat it. Later she came with a complaint of numerous urticated papules and plaques on her trunk, neck, both upper and lower limbs, and febrile since 4days. And we used the Regi SCAR scoring system that grades DRESS cases as ‘no’, ‘possible’, ‘probable’ or ‘definite’ groups for diagnostic criteria of DRESS. And we also applied Naranjo’s causality assessment scale in the following case study.
 Results and conclusion: In the initial recognition of DRESS syndrome and the immediate withdrawal of offending drugs and continuing with a supportive therapy and corticosteroids as needed. Systemic corticosteroids can reduce symptoms of hypersensitivity reactions.
 Keywords: Drug Reaction with Eosinophilia and Systemic Symptoms, Phenytoin, Exfoliation of Skin, Corticosteroids.