DOI: 10.36347/sjmcr.2023.v11i03.012

Pages: 295-298

Introduction: Drug reaction syndrome with eosinophilia and systemic symptoms (DRESS) is a rare and potentially fatal hypersensitivity reaction, The reaction usually manifests as a febrile skin rash accompanied by lymphadenopathy and malaise between two and eight weeks after drug exposure. The pulmonary manifestations of DRESS are variable and may include interstitial pneumonia, pleural effusion, pneumonia, pulmonary nodules and (in the most severe cases) acute respiratory distress syndrome (ARDS). We report the observation of an acute eosinophilic pneumonitis which is unique in that it is part of a DRESS syndrome following the use of non-steroidal anti-inflammatory drugs and Ciprofloxacin. Observation: This was a 63-year-old patient admitted to the outpatient department of the Mohamed VI University Hospital in Marrakech for acute respiratory distress. Her history included a chronic depressive syndrome for 7 years under Taraxet and Deroxat; a megaloblastic anemia under Tardyferon; a non-dialyzed renal failure; a Gout having been under Zyloric for 7 months; a DRESS syndrome following the intake of non-steroidal anti-inflammatory drugs and Ciprofloxacin (Cystitis) having been hospitalized in the dermatology department 15 days before. The diagnosis of community-acquired pneumonia had been evoked and treated with Amoxicillin-clavulanic acid + Azithromycin (Suspicion of covid infection and appearance of Crazy Paving on thoracic Angioscanner), The evolution had been marked the following day by severe respiratory distress with hypoxia at 68% with MHC at 15, the respiratory frequency was at 51 cycles per minute with generalized cyanosis, signs of respiratory struggle. The blood gases on admission:Ph 7. 43 PaCo2 40.3 pAo2 45 HCo3- 25.8, PaO2/FiO2 at 98; The picture of hypoxaemia on a severe and very hypoxaemic pneumopathy required orotracheal intubation. Refractory hypoxemia (PaO2/FIO2 = 69 in the control gasometry despite a PEEP = 14 cmH2O, deep sedation completed with .....