An observed repeat case of drug reaction with eosinophilia and systemic symptoms syndrome with modified anti-tuberculosis therapy: a case report

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, while uncommon, presents a potentially hazardous condition. It is a drug-induced multi‑system immunological hypersensitivity reaction, characterized by the triad of fever, rash, and internal organ involvement. This is a case report of a 60-year-old Indian female who developed a repeat episode of DRESS syndrome following modified anti-tuberculosis therapy (ATT). She had a past history of DRESS syndrome caused by first-line antitubercular drugs. This case report aims to highlight the challenges in managing DRESS syndrome in the context of tuberculosis (TB) treatment, as well as to emphasize the importance of prompt withdrawal of the culprit drugs and immediate initiation of appropriate supportive care. This case report also highlights the high risk of recurrence of DRESS syndrome following the re-administration of the offending medication, especially antitubercular drugs.