A Case of Drug-Induced Lung Injury With Systemic Features Resembling DRESS Caused by Saiko-Ka-Ryukotsu-Borei-To and Goreisan.

A 52-year-old man developed fever 3 days after starting Saiko-ka-ryukotsu-borei-to and Goreisan and was admitted with respiratory failure 16 days later. He showed trunk rash, blood eosinophilia, atypical lymphocytes and elevated liver enzymes. Chest computed tomography demonstrated interlobular septal thickening with patchy ground-glass opacities. Bronchoalveolar lavage fluid showed lymphocytosis with mild eosinophilia. Discontinuation of both drugs and corticosteroid therapy improved his clinical and radiological findings. This case represents drug-induced lung injury with systemic features resembling drug reaction with eosinophilia and systemic symptoms (DRESS), highlighting the importance of considering herbal medicines as potential causes.