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Patient presents in ER with symptoms and history indicative of infectious disease, with muscle pain and double vison being the main complaints. After several consultations, it is decided to admit the patient to the internal medicine ward, where following clinical investigation focused on a differential diagnosis of eosinophilia and myopathy. Paciente acude al servicio de urgencias con un cuadro compatible con patología infecciosa, siendo dolor muscular y visión doble las principales quejas. Tras consultar con diferentes servicios, se decide ingreso en el servicio de medicina interna, donde la investigación clínica se focaliza en un diagnóstico diferencial de eosinofilia y miopatía.

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El síndrome de DRESS es una toxicodermia asociada a eosinofilia con síntomas sistémicos. Presentamos un caso de dicho síndrome tras inicio de Levetiracetam con buena evolución tras inicio de corticoides y retirada del fármaco. Este síndrome, poco conocido y probablemente infradiagnosticado, puede ser potencialmente letal si no se trata de forma precoz.

Drug reaction with eosinophilia and systemic symptoms syndrome (DRESS Syndrome) is caused by many different aetiological factors. We present the case of a 56-year-old woman who started allopurinol treatment about 3 weeks before. She presented with fever, hypotension, tachycardia, generalized maculopapular cutaneous rash, facial edema and axillar, inguinal and cervical enlarged lymph nodes. Complementary diagnostic exams: slight lymphocytosis, eosinophilia, acute renal failure, elevated hepatic enzymes. Swab for SARS-CoV-2 was positive. Serologic tests for another virus were negative. Histopathological analysis was compatible with DRESS syndrome. SARS-CoV-2 could also be taken into account when suspected DRESS syndrome.