A 13-year-old girl is brought to the hospital by her father because of a worsening pruritic skin rash and fever. Five weeks ago, she was diagnosed with seizure and treatment with phenytoin was begun. Her immunizations are up-to-date. Her temperature is 38.8°C (101.8°F). There is a diffuse confluent erythema involving 65% of the body, palpable generalized lymphadenopathy, and symmetrical facial swelling. Which of the following laboratory findings is most likely to be present in this patient?

Question

A 13-year-old girl is brought to the hospital by her father because of a worsening pruritic skin rash and fever. Five weeks ago, she was diagnosed with seizure and treatment with phenytoin was begun. Her immunizations are up-to-date. Her temperature is 38.8°C (101.8°F). There is a diffuse confluent erythema involving 65% of the body, palpable generalized lymphadenopathy, and symmetrical facial swelling.  Which of the following laboratory findings is most likely to be present in this patient?

Quizplus · Accepted Answer

Eductional Objective: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome typically occurs 2-8 weeks after exposure to high-risk drugs such as anticonvulsants (eg, phenytoin, carbamazepine), allopurinol, sulfonamides (eg, sulfasalazine), and antibiotics (eg, minocycline, vancomycin). Patients typically develop fever, generalized lymphadenopathy, facial edema, diffuse skin rash, eosinophilia, and internal organ dysfunction.

A 13-Year-Old Girl Is Brought to the Hospital by Her