Differential Diagnosis for DRESS Syndrome
Single Most Likely Diagnosis
- DRESS Syndrome (Drug Reaction with Eosinophilia and Systemic Symptoms): This is the most likely diagnosis given the context of the question. DRESS syndrome is a severe skin and systemic reaction to medications, characterized by fever, rash, lymphadenopathy, and internal organ involvement, often accompanied by eosinophilia.
Other Likely Diagnoses
- Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN): These conditions are also severe skin reactions, often drug-induced, but they primarily involve the skin and mucous membranes, with less emphasis on systemic symptoms like eosinophilia and lymphadenopathy compared to DRESS.
- Acute Generalized Exanthematous Pustulosis (AGEP): This is a skin condition characterized by numerous small, sterile pustules on a background of erythema, often triggered by medications. While it can be severe, it tends to have fewer systemic symptoms than DRESS.
- Hypersensitivity Vasculitis: This condition involves inflammation of blood vessels and can be triggered by drugs, among other causes. It presents with skin lesions, but systemic involvement can vary.
Do Not Miss Diagnoses
- Sepsis: Although less likely to present with the specific constellation of symptoms seen in DRESS, sepsis is a life-threatening condition that can cause fever, rash, and organ dysfunction. It must be considered, especially if the patient shows signs of severe infection.
- Malignant Lymphoma: Certain types of lymphoma can present with systemic symptoms, lymphadenopathy, and skin lesions, making them important to rule out, especially in patients with persistent or unexplained symptoms.
- Autoimmune Disorders (e.g., Lupus, Rheumatoid Arthritis): These conditions can cause a wide range of systemic symptoms, including skin rashes, fever, and lymphadenopathy, and must be considered in the differential diagnosis.
Rare Diagnoses
- Eosinophilia-Myalgia Syndrome: A rare condition associated with the ingestion of contaminated tryptophan supplements, characterized by severe muscle pain and elevated eosinophil counts.
- Churg-Strauss Syndrome (Eosinophilic Granulomatosis with Polyangiitis): A rare autoimmune condition that involves asthma, high levels of eosinophils, and vasculitis. It can present with skin lesions, fever, and systemic symptoms.
- Histiocytosis: A group of rare diseases involving abnormal proliferation of histiocytes, which can cause a variety of systemic symptoms, including skin lesions and organ dysfunction.