Two cases of overlap-severe cutaneous adverse reactions to benznidazole treatment for asymptomatic Chagas′ disease in a non-endemic country

Abstract

Chagas′ disease is a parasitosis endemic to South America normally treated with benznidazole as first choice, which has been associated with numerous cutaneous reactions. However, very few benznidazole-associated severe cutaneous adverse reactions (SCARs) have been reported to date. The rise of Chagas′ disease in non-endemic countries represents a growing public health challenge.

We report two patients who met the criteria for DRESS (Drug Rash with Eosinophilia and Systemic Symptoms) syndrome and SJS/TEN (Stevens-Johnson syndrome / Toxic Epidermal Necrolysis) according to the RegiSCAR scoring systems—thus, deemed overlapping cases—with LTT (lymphocyte transformation test) positive for benznidazole. Both required intensive care unit admission (ICU), and both survived.

Considering the rising application of this drug for trypanosomyasis in immigrant populations, clinicians should be aware of this newly reported, potentially life-threatening risk.

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