Vancomycin-Induced DRESS Syndrome: An Important Concern in Orthopedic Surgery
Table 1
RegiSCAR scoring system for classifying cases of DRESS [7].
Score
−1
0
1
2
Fever > 38.4
No
Yes
Enlarged lymph nodes
No
Yes
Eosinophilia
No
0.7–1.499 × 10−9/L
>1.5 × 10−9/L
Atypical lymphocytes
No
Yes
Skin rash > 50% body surface area
No
Yes
Skin rash suggesting DRESS
No
Yes
Biopsy suggesting DRESS
No
Yes
Organ involvement
No
1 organ
2 or more organs
Resolution > 14 days
No
Yes
Evaluation of other potential causes (>2 negative of ANA, blood culture, hepatitis A/B/C, and chlamydia/mycoplasma)
Yes
Score: <2 no case, 2-3 possible case, 4-5 probable case, >5 definite case. The diagnostic criteria met by this case are highlighted in italics, totaling a score of 5. If the enlarged lymph nodes and cardiac involvement are taken to be as a result of DRESS, the score rises to 7.
