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Reactivation of DRESS syndrome in an elderly patient: case report A 71-year-old man experienced reactivation of DRESS syndrome following intradermal testing with meropenem and vancomycin [dosages not stated]. The man received multiple antibacterial agents for a paraspinal abscess. Prior to onset, he had received treatment with piperacillin/tazobactam, vancomycin and meropenem. Three weeks after initiating antibacterial therapy, he developed an erythematous, maculopapular, confluent rash with generalised oedema. The rash was associated with a fever, eosinophilia, systemic illness, and worsening of renal and liver function; DRESS syndrome was diagnosed. His symptoms resolved following treatment with steroids. Eight months later, antibacterial skin testing was performed. An early intradermal test with vancomycin generated a strongly positive result to a 1/100 dilution and a weakly positive result to a 1/1000 dilution. A late reading (48 hours to 6 days) was positive to vancomycin and meropenem, suggesting a delayed hypersensitivity to these agents and probable causes of DRESS syndrome. Two weeks after the intradermal tests, he developed a further generalised, indurated and pruritic maculopapular rash, which was less severe but of similar nature and distribution to the initial rash associated with DRESS syndrome. [Patient outcome not stated]. Dua S, et al. Reactivation of DRESS syndrome by intradermal tests. Allergy 66 (Suppl. 94): 86, Jun 2011. Available from: URL: http://dx.doi.org/10.1111/ 803068213 j.1398-9995.2011.02604.x [abstract] - United Kingdom

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Reactions 24 Mar 2012 No. 1394