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<p>Drug-induced hypersensitivity syndrome (DIHS) is a potentially life-threatening reaction. The pathology of DIHS has been connected with adverse reactions to drugs; however, it has been observed that viruses and other infectious factors may induce similar responses in the body. COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has recently become a major challenge for worldwide healthcare. The dermatological symptoms occur in approximately 5.95% of COVID-19 patients, however, they are not exclusively a manifestation of SARS-CoV-2 infection.</p>
<p>Certain skin-related symptoms might result from therapeutic drug administration, personal protective equipment, or sanitizers used by medical personnel. The complex pathomechanism of those symptoms leads to multiple diagnostic difficulties. This article describes a case of a 40-year-old man who was admitted to the intensive care unit (ICU) due to heavy respiratory failure in the course of SARS-CoV-2 infection. The patient has been treated with olanzapine for anxiety disorder for approximately 4 years. On the seventh day of treatment, the patient presented with a maculopapular rash, fever, and swollen upper lip. Because of these presented symptoms, the patient has been diagnosed with drug-induced hypersensitivity syndrome (DIHS). The results of blood analysis showed elevated levels of acute phase markers, liver and kidney damage markers, which are present both during COVID-19 and DIHS. Furthermore, the patient presented with peripheral eosinophilia, which is a distinctive feature of DIHS. In the course of COVID-19, the laboratory-measured levels of eosinophilic granulocytes declined to 0. Therefore, in the active phase of SARS-CoV-2 infection, the eosinophilia connected with DIHS was difficult to assess. In this paper, we compare and contrast the clinical and laboratory symptoms of COVID-19 and DIHS syndrome, describe patient's case and explain the diagnostics difficulties resulting from the concomitance of those disease entities.</p>
</abstract>

Drug-induced hypersensitivity syndrome (DIHS) is a potentially life-threatening reaction. The pathology of DIHS has been connected with adverse reactions to drugs; however, it has been observed that viruses and other infectious factors may induce similar responses in the body. COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has recently become a major challenge for worldwide healthcare. The dermatological symptoms occur in approximately 5.95% of COVID-19 patients, however, they are not exclusively a manifestation of SARS-CoV-2 infection.
Certain skin-related symptoms might result from therapeutic drug administration, personal protective equipment, or sanitizers used by medical personnel. The complex pathomechanism of those symptoms leads to multiple diagnostic difficulties. This article describes a case of a 40-year-old man who was admitted to the intensive care unit (ICU) due to heavy respiratory failure in the course of SARS-CoV-2 infection. The patient has been treated with olanzapine for anxiety disorder for approximately 4 years. On the seventh day of treatment, the patient presented with a maculopapular rash, fever, and swollen upper lip. Because of these presented symptoms, the patient has been diagnosed with drug-induced hypersensitivity syndrome (DIHS). The results of blood analysis showed elevated levels of acute phase markers, liver and kidney damage markers, which are present both during COVID-19 and DIHS. Furthermore, the patient presented with peripheral eosinophilia, which is a distinctive feature of DIHS. In the course of COVID-19, the laboratory-measured levels of eosinophilic granulocytes declined to 0. Therefore, in the active phase of SARS-CoV-2 infection, the eosinophilia connected with DIHS was difficult to assess. In this paper, we compare and contrast the clinical and laboratory symptoms of COVID-19 and DIHS syndrome, describe patient's case and explain the diagnostics difficulties resulting from the concomitance of those disease entities.

A patient infected with SARS-Cov-2 presents with DIHS syndrome induced by olanzapine: diagnostic difficulties

Medical University of Lublin: Uniwersytet Medyczny w Lublinie

Postępy Higieny i Medycyny Doświadczalnej

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Drug-induced hypersensitivity syndrome (DIHS) is a potentially life-threatening reaction. The pathology of DIHS has been connected with adverse reactions to...

A patient infected with SARS-Cov-2 presents with DIHS syndrome induced by olanzapine: diagnostic difficulties

Article Category: Review

Published Online: Oct 08, 2023

Page range: 99 - 106

Received: Mar 12, 2023

Accepted: Aug 10, 2023

DOI: https://doi.org/10.2478/ahem-2023-0016

Keywords
drug-induced hypersensitivity syndrome, drug reaction with eosinophilia and systemic symptoms COVID-19, olanzapine

© 2023 Michalina Pinkosz et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

A patient infected with SARS-Cov-2 presents with DIHS syndrome induced by olanzapine: diagnostic difficulties

Article Category: Review

Published Online: Oct 08, 2023

Page range: 99 - 106

Received: Mar 12, 2023

Accepted: Aug 10, 2023

DOI: https://doi.org/10.2478/ahem-2023-0016

Keywordsdrug-induced hypersensitivity syndrome, drug reaction with eosinophilia and systemic symptoms COVID-19, olanzapine

© 2023 Michalina Pinkosz et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Keywords
drug-induced hypersensitivity syndrome, drug reaction with eosinophilia and systemic symptoms COVID-19, olanzapine