DRESS is key to diagnostic success

If the patient is afebrile with no lymphadenopathy and has blood eosinophils then it’s likely a drug reaction, and usually the offender is the most recent drug taken.

In this case it was carbamazepine, taken for an atypical pain syndrome, and started three weeks prior. This patient also had raised liver enzymes and respiratory problems making it likely her drug reaction was part of the DRESS syndrome (Drug Reaction with Eosinophilia and Systemic Symptoms).

Such patients