Reactivation of Cytomegalovirus (CMV) in a Patient with Drug Hypersensitivity Syndrome (Drug Reaction with Eosinophilia and Systemic Symptoms, DHS, DRESS)
Mizukawa et al reported evaluation of a patient with reactivation of cytomegalovirus (CMV) in a patient being treated for drug hypersensitivity syndrome (drug reaction with eosinophilia and systemic symptoms, DHS, DRESS). The authors are from Kyorin University and Saitama Medical University in Japan.
Patient selection: DHS/DRESS
Parameters:
(1) DHS/DRESS severity score, early, using the score of Mizukawa et al
(2) change in DHS/DRESS score
Early Score
Status
Corticosteroid Therapy
-2 to 0
mild
none
1 to 3
moderate
systemic (< 50 mg/day)
>= 4
severe
systemic (50 mg/day)
Change in Score
Test for CMV?
Corticosteroid Therapy
decrease
no
taper gradually
no change or increase
yes, thorough
tape gradually
If CMV positive, then start anti-viral agents immediately.
In all patients investigate for progression to autoimmune disease.
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