Fatal Drug Rash

We describe the case of a woman presenting with rash and fever 3 weeks after starting oxcarbazepine. She had a convoluted, prolonged hospital course involving reactions to multiple structurally-different medications, with a variety of severe manifestations including drug rash with eosinophilia and systemic symptoms (DRESS), and Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), and complicated with MRSA septic shock and death. This case illustrates the high risk in subjects with a drug reaction that initiated excessive T cell stimulation with subsequent reactions to multiple drugs.