Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Jun 11;16(6):e62125.
doi: 10.7759/cureus.62125. eCollection 2024 Jun.

Metronidazole-Induced Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome With Parvovirus B19 Reactivation: A Pediatric Case

Bahaeddine Dridi  1   2 , Myriam Agrebi  1 , Dhouha Sahnoun  1 , Chaker Ben Salem  1
Affiliations
Case Reports

Metronidazole-Induced Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) Syndrome With Parvovirus B19 Reactivation: A Pediatric Case

Bahaeddine Dridi et al. Cureus. .

Abstract

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe and rare syndrome that causes life-threatening organ dysfunctions. Here, we present the case of a 10-year-old child who developed a pruritic erythematous eruption, fever, facial edema, and lymphadenopathy seven days after receiving intravenous metronidazole (20 mg/kg/day), vancomycin (50 mg/kg/day), and cefotaxime (200 mg/kg/day). Laboratory tests showed eosinophilia and liver damage as well as positive parvovirus B19 IgM and IgG indicating viral reactivation. Vancomycin was initially discontinued and later reintroduced with no ill effects. The patient was managed with topical corticosteroid emollients and cetirizine and improved within seven days of metronidazole withdrawal. Treatment with cefotaxime was continued and showed no adverse effects.

Keywords: dress and viruses; dress syndrome; drug reaction with eosinophilia and systemic symptoms; metronidazole side effects; parvovirus b-19; pediatrics; pharmaco-vigilance; pharmacology.

PubMed Disclaimer

Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Diffuse morbilliform rash over the arms
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. The variable clinical picture of drug-induced hypersensitivity syndrome/drug rash with eosinophilia and systemic symptoms in relation to the eliciting drug. Kano Y, Shiohara T. Immunol Allergy Clin North Am. 2009;29:481–501. - PubMed
    1. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome. Choudhary S, McLeod M, Torchia D, Romanelli P. http://pubmed.ncbi.nlm.nih.gov/23882307/ J Clin Aesthet Dermatol. 2013;6:31–37. - PMC - PubMed
    1. Drug reaction with eosinophilia and systemic symptoms (DRESS) in the pediatric population: a systematic review of the literature. Kim GY, Anderson KR, Davis DM, Hand JL, Tollefson MM. J Am Acad Dermatol. 2020;83:1323–1330. - PubMed
    1. Severe cutaneous adverse drug reactions in pediatric patients: a multicenter study. Dibek Misirlioglu E, Guvenir H, Bahceci S, et al. J Allergy Clin Immunol Pract. 2017;5:757–763. - PubMed
    1. A method for estimating the probability of adverse drug reactions. Naranjo CA, Busto U, Sellers EM, et al. Clin Pharmacol Ther. 1981;30:239–245. - PubMed

Publication types

LinkOut - more resources