Afebrile vancomycin-induced delayed hypersensitivity suggestive of incomplete drug rash with eosinophilia and systemic symptoms syndrome: a case report

This case highlights an atypical presentation of vancomycin-induced delayed hypersensitivity with incomplete drug reaction with eosinophilia and systemic symptoms syndrome due to the absence of fever, potentially masked by nonsteroidal anti-inflammatory drug treatment. Clinicians should remain vigilant for atypical presentations of drug hypersensitivity reactions, especially in patients concurrently taking nonsteroidal anti-inflammatory drugs that can suppress fever.