Introduction

Drug reaction with eosinophilia and systemic symptoms (DRESS syndrome) is an uncommon yet potentially fatal hypersensitivity reaction triggered by specific medications. A typical clinical presentation consists of maculopapular skin lesions, eosinophilia, fever and internal organ involvement.

Case report

This report highlights 2 cases of the DRESS syndrome caused by antiepileptic drug – lamotrigine and antibiotic – azithromycin. The first case involves an 18-year-old who developed widespread maculopapular rash, fever, lymphadenopathy, and elevated liver enzymes 3 weeks after initiating lamotrigine. The second case describes a 53-year-old female with severe rash covering 90% of her body, eosinophilia, and liver enzyme abnormalities shortly after azithromycin administration. Immediate discontinuation of the drug, combined with topical and systemic corticosteroids treatment led to the desired outcomes in both cases.

Conclusions

These cases underscore the critical importance of early diagnosis and management of DRESS, particularly when prescribing commonly used medications such as antiepileptic drugs and antibiotics.