PT  - JOURNAL ARTICLE
AU  - Abheek Sil
AU  - Moni Sankar Bhattacharjee
AU  - Atanu Chandra
AU  - Jayasri Das Pramanik
TI  - Sulfasalazine-induced drug reaction with eosinophilia and systemic symptoms (DRESS) with concomitant acute chikungunya virus infection: possible role of new viral trigger
AID  - 10.1136/bcr-2021-244063
DP  - 2021 Oct 01
TA  - BMJ Case Reports
PG  - e244063
VI  - 14
IP  - 10
4099  - http://casereports.bmj.com/content/14/10/e244063.short
4100  - http://casereports.bmj.com/content/14/10/e244063.full
SO  - BMJ Case Reports2021 Oct 01; 14
AB  - Drug reaction with eosinophilia and systemic symptoms (DRESS) is designated as a potentially lethal adverse drug effect with characteristic signs and symptoms such as skin rash, fever, leucocytosis with eosinophilia or atypical lymphocytes, lymphadenopathy and liver or renal dysfunction. In addition to most commonly implicated drug category (aromatic anticonvulsants), lamotrigine, sulfonamides, dapsone and abacavir may also induce this syndrome. We describe here a case a sulfasalazine-induced DRESS with coexisting chikungunya fever. The shared presentation of fever with rash in both conditions made it a challenging diagnosis. Sulfasalazine hypersensitivity manifesting as DRESS has rarely been reported. Furthermore, we document chikungunya virus (CV) as a possible triggering agent for DRESS. To the best of our knowledge, CV as a viral aetiology in DRESS has not been reported previously in the literature.