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Drug Hypersensitivity Syndrome Induced by Meglumine Antimoniate

Fakhri JeddiService de Parasitologie-Mycologie, et Service de Maladies Infectieuses et Tropicales, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Unité de Mycologie Moléculaire, Institut Pasteur, Paris, France

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Eric CaumesService de Parasitologie-Mycologie, et Service de Maladies Infectieuses et Tropicales, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Unité de Mycologie Moléculaire, Institut Pasteur, Paris, France

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Marc ThellierService de Parasitologie-Mycologie, et Service de Maladies Infectieuses et Tropicales, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Unité de Mycologie Moléculaire, Institut Pasteur, Paris, France

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Stéphane JauréguiberryService de Parasitologie-Mycologie, et Service de Maladies Infectieuses et Tropicales, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Unité de Mycologie Moléculaire, Institut Pasteur, Paris, France

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Dominique MazierService de Parasitologie-Mycologie, et Service de Maladies Infectieuses et Tropicales, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Unité de Mycologie Moléculaire, Institut Pasteur, Paris, France

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Pierre A. BuffetService de Parasitologie-Mycologie, et Service de Maladies Infectieuses et Tropicales, Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Unité de Mycologie Moléculaire, Institut Pasteur, Paris, France

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We report a case of drug hypersensitivity syndrome (drug reaction with eosinophilia and systemic symptoms [DRESS]) induced by parenteral meglumine antimoniate (Glucantime) in a 40-year-old man who traveled to Bolivia and was treated for mucocutaneous leishmaniasis. Two weeks after starting therapy, the patient had fever, joint pain, a cutaneous eruption, and hypereosinophilia (1,358 cells/mm3). These symptoms resolved after drug withdrawal but reappeared upon reintroduction of the drug. Pentavalent antimonials should be definitively withdrawn in patients with hypereosinophilia > 1,000 cells/mm3 accompanied by systemic manifestations consistent with DRESS.

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