Case Report - Hypersensitivity and dose related side effects of phenytoin mimicking critical illness

OBJECTIVE: To describe phenytoin-induced rare hypersensitivity and dose related reactions, emphasizing the importance of early omission of drug to achieve clinical improvement.
DESIGN: Case series and review of literature.
SETTING: Tertiary level medical intensive care unit.
PATIENTS: Three cases, two of whom had hypersensitivity reactions and the third had drug-induced dyskinesia.
INTERVENTION: Omission of phenytoin and corticosteroid therapy in two cases.
RESULTS: Improvement and discharge.
CONCLUSION: A high index of suspicion of drug-induced complications is necessary especially when multiple drugs are being administered to critically ill patients.

Keywords
Phenytoin, skin lesion, allergic alveolitis, dyskinesia, Phenytoin hypersensitivity syndrome (PHS)