Phenytoin-induced drug rash with eosinophilia and systemic symptoms syndrome in a child: A rare but serious adverse drug reaction.

Authors

H S Rajani, D Narayanappa, S N Prashanth, C Chandrashekhar

Published in

Indian journal of pharmacology. Volume 58. Issue 4. Pages 478-480. Jul 01, 2026. Epub Jul 01, 2026.

Abstract

Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome is a rare, potentially fatal adverse drug reaction (ADR) most associated with anticonvulsants. Paediatric cases are uncommon and may present with atypical or early onset, posing diagnostic challenges. We report the case of a 10-year-old boy who developed high-grade fever, generalized maculopapular rash, lymphadenopathy, eosinophilia, and hepatic involvement shortly after initiation of phenytoin for epilepsy. Infectious causes were excluded. The patient fulfilled RegiSCAR criteria for definite DRESS (score = 7). Prompt withdrawal of phenytoin and initiation of systemic corticosteroids resulted in complete recovery. This case highlights the importance of early recognition of DRESS syndrome as a serious ADR, even when onset occurs earlier than the classical latency period.

PMID:
42583984
Bibliographic data and abstract were imported from PubMed on 12 Aug 2026.

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