A 50-year-old man develops DRESS syndrome after 5 weeks of phenytoin therapy. Which viral reactivation is most strongly associated with the severity and prolonged course of DRESS syndrome?
- A Cytomegalovirus (CMV)
- B Human herpesvirus 6 (HHV-6) ✓
- C Epstein-Barr virus (EBV)
- D Parvovirus B19
Correct answer: B. Human herpesvirus 6 (HHV-6)
Explanation
Human herpesvirus 6 (HHV-6) reactivation is most strongly associated with DRESS syndrome severity and its relapsing, prolonged course. HHV-6 reactivation can be detected in most severe cases and correlates with flares and organ involvement. It is considered a hallmark of DRESS pathophysiology, distinguishing it from other drug reactions. CMV and EBV may occasionally reactivate but are not the defining viral association.
Reference: Harrison's Principles of Internal Medicine, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.