Carbamazepine-Induced DRESS Syndrome During Epstein-Barr Virus Reactivation in an Adolescent.

Drug reaction with eosinophilia and systemic symptoms (DRESS) is a rare and potentially life-threatening syndrome. Herein, we present the case of a 14-year-old female who developed a diffuse erythematous rash with fever and facial edema 6 weeks after initiating treatment with carbamazepine and sertraline. Laboratory tests showed an inflammatory reaction, elevated liver enzymes, and mild eosinophilia. Serology tests were negative for viral hepatitis, cytomegalovirus, herpes simplex virus, and parvovirus B19, but positive anti-VCA IgM and anti-EBNA IgG confirmed the presence of Epstein-Barr virus reactivation. Drugs were withdrawn, and the patient was treated with corticosteroid. Carbamazepine was identified as the culprit drug after performing patch tests. Even though DRESS is rare in childhood, we present another case of carbamazepine-induced DRESS in an adolescent associated with EBV activation.