A fatal presentation of DRESS syndrome with multiple visceral failure mimicking septic shock

INTRODUCTION: The DRESS syndrome is a life-threatening multi-organ system reaction induced by drugs Characterized by a long latency between drug exposure and disease onset, allopurinol is the most incriminated drug. CASE PRESENTATION: We report a case of 56-year-old patient with history of gout under allopurinol admitted in emergency for shock state associated erythematosquamous lesions reaching 65% of the body surface, a septic was suspected but the bacteriological investigations were negative and the patient had an isolated hyper eosinophilia so diagnosis of dress syndrome induced by allopurinol was retained The patient presented an acute renal failure that was treated successfully by renal replacement therapy, and corticosteroids. DISCUSSION: DRESS syndrome has a mortality of 10–20%. Its clinical presentation is predominantly cutaneous, with or without visceral involvement. The cornerstone of the management of DRESS syndrome is the identification and discontinuation of the causative drug. Early diagnosis and screening for visceral involvement can reduce mortality. CONCLUSION: The DRESS syndrome is a severe adverse drug reaction and has high mortality rates Furthermore, judicious use of allopurinol may decrease its incidence.