164 Sociedad Chilena de Pediatría Rev Chil Pediatr. 2017;88(1):164-168 DOI: 10.1016/j.rchipe.2016.05.010 ClInICal Case Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome in pediatrics. Clinical case Síndrome de sensibilidad a fármacos con eosinofilia y síntomas sistémicos en pediatría. Caso clínico Marcos Silva-Feistner a , Elena Ortiz a , María Jesús Rojas-Lechuga b , Daniel Muñoz a a Department of Dermatology, Pontifcia Universidad Católica de Chile, Santiago, Chile b Pontifcia Universidad Católica de Chile, Santiago, Chile Recibido el 20 de noviembre de 2015; aceptado el 30 de mayo de 2016 Correspondence: Marcos Silva-Feistner marcos.silva.feistner@gmail.com Keywords: Drug reaction with eosinophilia and systemic symptoms; Drug-induced hypersensitivity reaction; Ceftriaxone; Paediatrics. Abstract Introduction: Drug reaction with eosinophilia and systemic symptoms (DRESS) is a potentially life- threatening, drug-induced hypersensitivity reaction that includes skin eruptions, fever, lymphade- nopathy, hematological abnormalities, and internal organ involvement. Objective: To present a rare condition in children; to facilitate a rapid diagnostic suspicion and recognition by doctors. Case report: A 9 months old infant admitted due to a severe viral pneumonia, treated with non-invasive ventilation and ceftriaxone, among other medications. Five days after stopping antibiotics, a violet- colored maculopapular rash appeared, confluent predominantly in the trunk, face and upper extre- mities, combined with a fever, eosinophilia, and elevated transaminases. She was treated with oral prednisone and topical corticosteroids for 6 weeks, with good results at 3 months follow-up. Conclu- sions: The diagnosis of DRESS syndrome is made using clinical criteria and laboratory examinations, as well as a skin biopsy in the case of any doubt in the diagnostics. Although it is most frequently cau- sed by anticonvulsants, many other drugs have been implicated. Management consists of disconti- nuing the suspected drug associated with the reactions and a prolonged treatment of corticosteroids. Introduction A clinical presentation of exanthema associated with fever and lymphadenopathy represents a diag- nostic challenge for a physician in terms of etiology, whether viral or drug-related. A high degree of sus- picion should be given to this situation and a broad spectrum of differential diagnoses should be used, since adverse skin reactions to drugs are life-threate- ning, and an accurate diagnosis can affect the patient’s prognosis. Severe, adverse skin reactions to medications are less frequent in children than in adults, but potentia- lly severe, with a mortality rate estimated at 10% for DRESS syndrome, 1-5% for Stevens-Johnson syndro- me, 25-30% for toxic epidermal necrolysis and less