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Phenytoin is one of the most commonly prescribed drugs in the United States.Whereas myriad systemic side effects have been associated with its use,pulmonary complications are rarely observed.We report on a patient with phenytoin-induced multisystemic disease who presented with fever, diffuse bronchial wheezing,and both peripheral blood and sputum eosinophilia.Her course was complicated by acute respiratory failure requiring mechanical ventilation,acute renal failure,and hepatic failure. Rapid improvement following administration of high-dose corticosteroids permitted weaning from mechanical ventilation within 24 hours.The patient' s systemic symptoms were exacerbated by inadvertent rechallenge with intravenous phenytoin and were cleared without recurrence following its discontinuation. |
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