• Laetitia Vauthey, Ilker Uçkay, Sophie Abrassart, Louis Bernard, Mathieu Assal, Tristan Ferry, Marina Djordjevic, Constantinos Roussos, and Pierre Vaudaux.
• Orthopaedic Surgery Service, University Hospitals of Geneva, Geneva, Switzerland.
• Pharmacology. 2008 Jan 1; 82 (2): 138-41.

BackgroundDRESS syndrome (drug rash with eosinophilia and systemic symptoms) is a hypersensitivity reaction with skin rashes, eosinophilia, fever, lymph node enlargement and internal organ involvement.Case ReportA 60-year-old diabetic woman was hospitalized at the University Hospitals of Geneva for mid-leg amputation due to peripheral arterial occlusive disease. No drug allergy was reported. Because of a wound infection by methicillin-resistant Staphylococcus aureus, treatment with vancomycin (2 g/day) in continuous perfusion was initiated. Approximately 2 weeks later, she developed a toxidermia with fever, a progressive maculopapular skin rash, eosinophilia and acute renal insufficiency. The skin biopsy revealed a necrosis with lymphocytic and eosinophilic infiltrations, supporting the suspicion of DRESS syndrome. A cure was achieved by the withdrawal of vancomycin and the administration of methylprednisolone (1 g/day), antihistaminics and topical mometasone, without the introduction of other antibiotics.ConclusionVancomycin can be a cause of DRESS syndrome. A high index of suspicion is warranted in order not to miss this potentially lethal disease.Copyright 2008 S. Karger AG, Basel.

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