Introduction
Drug reaction with eosinophilia and systemic symptoms (DRESS) is also known as drug-induced hypersensitivity (DiSH) or drug-induced delayed multi-organ hypersensitivity syndrome. It is one of the severe cutaneous adverse reactions to drugs (SCAR) syndrome, characterized by cutaneous features of variable morphology and systemic organ involvement [1,2]. Certain genetic predispositions and drug-virus interactions are hypothesized to be the underlying pathogenesis of DRESS [2,3]. Herein, we report a case of a young female who developed DRESS with acute respiratory failure due to sulfasalazine/hydroxychloroquine with reactive Ebstein-Barr virus and human herpes virus-6.