The case of the magenta woman (DRESS syndrome).

Drug reaction with eosinophilia and systemic symptoms, otherwise known as DRESS syndrome, is a rare, potentially life-threatening drug-induced hypersensitivity reaction that primarily involves a widespread skin rash, fever, hematological abnormalities, lymphadenopathy, and organ injury. Anti-epileptics, sulfonamides, and allopurinol are the most common triggers, but other offending medications have been reported in the literature. Vancomycin has been increasingly reported over the past 5 years, with 26 cases reported to date. Here we describe a case of a 44-year-old woman who presented with a cutaneous drug reaction with single-organ damage to the kidneys, likely triggered by 1 month treatment of osteomyelitis with intravenous vancomycin. The patient's clinical picture was initially consistent with recurring red-man syndrome that eventually became persistent after failing treatment with infusion rate reduction and diphenhydramine. This case highlights the need for a detailed review of medications taken within 2 months of the onset of the rash, as well as the importance of being cognizant of medications that incite multiple drug reactions.