DRESS syndrome secondary to pyrazinamide: An uncommon complication of tuberculosis treatment

Introduction. - The Drug Reaction with Eosinophilia and Systemic Symptom (DRESS) is a severe drug-induced reaction. ase report. - We report the case of a 35-year-old man treated by RHEZ for a first episode of a smear positive pulmonary tuberculosis and who developed a DRESS syndrome due to pyrazinamide after twenty days of treatment, associated with a viral reactivation to Human Herpes Virus 6 (HHV6). He had a skin eruption, liver involvement and hypereosinophilia. He fully recovered after drug withdrawal, associated with local and general corticosteroids. He died two weeks after discharge. Conclusions. - Discovery of DRESS syndrome during tuberculosis treatment is an uncommon complication and requires a searching for the responsible drug. That should be difficult because tuberculosis drugs are often given as fixed-dose combination. Physicians have to bear in mind the potential role of pyrazinamide. (c) 2017 SPLF. Published by Elsevier Masson SAS. All rights reserved.