Acute onset of fever, eosinophilia, rash, acute kidney injury, and a positive Monospot test in a patient on lamotrigine: DRESS syndrome

A 20-year-old daycare teacher presented to our hospital reporting a generalised erythematous maculopapular rash. The patient also had a fever, myalgia, nausea, reduced urine output, peripheral oedema, and dyspnoea on exertion. She reported that the rash had rapidly increased in size over the past 72 h—coinciding with a doubling of the dose of her lamotrigine which she was prescribed for bipolar affective disorder.