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An event is serious (based on the ICH definition) when the patient outcome is:
* death
* life-threatening
* hospitalisation
* disability
* congenital anomaly
* other medically important event
A 75-year-old woman developed allergic reaction during treatment with amoxicillin/clavulanic-acid. Additionally, she developed confusion and DRESS-syndrome during treatment with allopurinol for acute gout [not all routes and indications stated; dosages not stated].
The woman had a history for ischaemic heart disease, breast cancer and pacemaker insertion. She had been receiving colchicine for acute gout, which later changed to allopurinol. Subsequently, she developed lethargy, was confused and did not recall where she was and was too weak to get out of bed. Also, she experienced a dry cough. A full septic screen including a COVID-19 swab was negative due to hypoactive delirium. Thereafter, she started receiving IV amoxicillin/clavulanic acid [Co-Amoxiclav] and treatment with allopurinol was stopped. Her blood test was significant for eosinophilia. After 2 days, she developed a diffuse erythematous rash all over the body. It was suspected that she had an allergic reaction to amoxicillin/clavulanic acid while DRESS syndrome and confusion to allopurinol.
Therefore, the woman's treatment with amoxicillin/clavulanic acid was changed to levofloxacin. However, she remained confused while rash slowly subsided over a week. Her cognition gradually returned to the baseline.
Reference
- Camilleri D, et al. A particular case of delirium. European Geriatric Medicine 12 (Suppl.): abstr. 527, Jan 2021. Available from: URL: 10.1007/s41999-021-00585-2 [abstract] [DOI]