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Case Reports
. 2024 Sep 11;16(9):e69160.
doi: 10.7759/cureus.69160. eCollection 2024 Sep.

A Rare Presentation of an Adverse Reaction to Minocycline

Francisca Manoel  1 , José Maria Lupi  1 , Isabel V Coelho  1 , Andreia Ferrão  2 , Joana Gaspar  1
Affiliations
Case Reports

A Rare Presentation of an Adverse Reaction to Minocycline

Francisca Manoel et al. Cureus. .

Abstract

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare, severe adverse drug reaction, usually associated with antibiotics and anticonvulsants. A 17-year-old girl with maculopapular rash, arthralgia, fever, and facial edema (plus eosinophilia and hepatitis) repeatedly goes to the emergency department, initially omitting having started minocycline three weeks before symptom onset. Diagnosis of serum-like sickness was first established, minocycline was suspended, and a short course of corticosteroid therapy was started. However, the fast taper of corticotherapy resulted in the reappearance of previous symptoms, as well as renal dysfunction and respiratory distress. Chest CT showed interstitial pneumonitis. With these findings, the final diagnosis of DRESS was made, and the re-adjustment of corticoid therapy resulted in symptom improvement. This case highlights the diagnostic and treatment challenges of DRESS and the importance of an all-around approach to the patient.

Keywords: drug reaction with eosinophilia and systemic symptoms (dress) syndrome; drug-induced eosinophilia; drug-induced pneumonitis; drug-induced urticarial rash; minocycline; pediatric drug reaction.

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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. Patient timeline
Figure 2
Figure 2. A. maculopapular rash with dermatographism; B. facial edema during symptomatic phase; C. improvement of facial edema after treatment
Figure 3
Figure 3. A and B. CT during the symptomatic phase; C and D. CT after treatment
CT: computed tomography
See this image and copyright information in PMC

References

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