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. 2016:2016:9453286.
doi: 10.1155/2016/9453286. Epub 2016 Jan 24.

DRESS Syndrome in the ICU: When a Patient Is Treated with Multiple Drugs

Florent Moriceau  1 , Johanne Prothet  1 , Benjamin J Blaise  2 , Benoit Ben Said  3 , Mathieu Page  1 , Charles-Eric Ber  1 , Jullien Crozon  1 , Thomas Rimmelé  4
Affiliations

DRESS Syndrome in the ICU: When a Patient Is Treated with Multiple Drugs

Florent Moriceau et al. Case Rep Crit Care. 2016.

Abstract

The Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome is life-threatening. It associates a skin condition with hematological and visceral disorders. The DRESS syndrome diagnosis in the intensive care unit (ICU) is difficult as clinical features are nonspecific. Furthermore, the need to treat patients with multiple drugs usually prevents the identification of the causative drug. We report the case of a patient who developed two bouts of DRESS caused by piperacillin-tazobactam, the first being complicated with a distributive shock. Cases of DRESS occurring inside ICU are seldom reported. However, any intensivist may encounter this situation during his career and should be aware of its diagnostic and management specific aspects.

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Figures

Figure 1
Figure 1
The chronology of events and drugs use related to DRESS occurrences. D: day; TZP: piperacillin-tazobactam; AMK: amikacin; CTX: ceftriaxone; VA: vancomycin; IMP: imipenem; LIN: linezolid; MP: methylprednisolone. Day 1: admission to the ICU.
Figure 2
Figure 2
Erythrodermia in ICU ventilated patient. Focus on the chest showing a maculopapular rash.
See this image and copyright information in PMC

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