A Young Child with Eosinophilia, Rash, and Multisystem Illness: Drug Rash, Eosinophilia, and Systemic Symptoms Syndrome After Receipt of Fluoxetine

Pediatr Dermatol. 2017 May;34(3):e120-e125. doi: 10.1111/pde.13131.


Drug rash, eosinophilia, and systemic symptoms (DRESS) syndrome is a severe systemic hypersensitivity reaction that usually occurs within 6 weeks of exposure to the offending drug. Diagnosis is usually straightforward in patients with pyrexia, skin rash, hepatitis, and eosinophilia with a preceding history of exposure to agents often associated with DRESS syndrome, such as aromatic anticonvulsants and sulfa drugs, but diagnosis of DRESS may still be a challenge. We report a 4-year-old child with probable DRESS syndrome complicated by multiple hematologic complications that developed 1 month after exposure to fluoxetine, a drug not known to be associated with such severe reactions.

Publication types

  • Case Reports

MeSH terms

  • Administration, Oral
  • Biopsy, Needle
  • Bone Marrow / pathology
  • Child, Preschool
  • Diagnosis, Differential
  • Drug Eruptions / diagnosis
  • Drug Eruptions / etiology
  • Drug Hypersensitivity Syndrome / diagnosis*
  • Drug Hypersensitivity Syndrome / drug therapy*
  • Eosinophilia / chemically induced
  • Eosinophilia / diagnosis
  • Female
  • Fluoxetine / administration & dosage
  • Fluoxetine / adverse effects*
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Prednisolone / therapeutic use*
  • Radiography, Thoracic / methods
  • Risk Assessment
  • Treatment Outcome


  • Fluoxetine
  • Prednisolone