Viral Reactivation in Hospitalized Patients With Drug Reaction With Eosinophilia and Systemic Symptoms: A Retrospective Study From a Tertiary Medical Center in the United States

This retrospective study conducted at The Ohio State University Wexner Medical Center from 2014 to 2019 involved 36 patients diagnosed with drug reaction with eosinophilia and systemic symptoms (DRESS). The study found that viral reactivation at the time of DRESS diagnosis was minimal to none for all tested viruses, including cytomegalovirus (CMV), Epstein-Barr virus (EBV), and human herpesviruses (HHV-6 and HHV-7). This contrasted with studies from Asia, which reported higher rates of viral reactivation weeks after diagnosis. The study concluded that viral studies at the time of initial DRESS diagnosis in the U.S. had low utility, and the timing of reactivation needs further investigation. Systemic steroids, although potentially increasing the risk of viral reactivation, were deemed essential for improved outcomes in DRESS. The study was limited by only testing serum for viral reactivation, not other body fluids.