Dress syndrome presenting like septic shock

摘要

A 27-year-old presents with pyrexia of 38.2degC, lethargy and a sore throat. On examination she had marked cervical, axillary and groin adenopathy. Pharyngitis with visible pus on her right tonsil was seen along with a widespread maculopapular rash, mild facial puffiness and genital ulceration. The only past medical history of note was a sero-negative arthropathy affecting her left fore-foot. She had commenced sulphasalazine 5 weeks prior to admission but had stopped taking it when she developed genital ulceration.