ANTI TUBERCULOSIS THERAPY INDUCED DRESS SYNDROME

Abstract

Background: Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) represents a

rare yet potentially fatal hypersensitivity reaction. Although various medications have been

associated with this condition, rifampicin is an infrequent culprit.

Case Presentation: A 72-year-old male with hypertension and a history of spinal surgeries

presented with fever, widespread pruritic rash, and edema following three weeks of empirical

treatment with Rifampicin. Assessment using RegiSCAR criteria resulted in a score of 6,

confirming a definitive diagnosis of DRESS syndrome. Laboratory tests indicated eosinophilia

(30%), elevated liver enzymes, and increased serum IgE levels (409 IU/ml). The patient was treated

with intravenous corticosteroids, followed by a tapering oral regimen, which resulted in significant

clinical and biochemical improvement.

Conclusion: Timely identification and immediate cessation of adverse effect of drug are crucial

for achieving favorable outcomes in DRESS syndrome. This case underscores the importance of

clinical awareness, even with frequently prescribed medications such as Rifampicin.