DRESS syndrome is a distinct severe adverse drug reaction characterized by skin rash, fever, and internal organ involvement. The marked eosinophilia that accompanies the disease can lead to life‐threatening organ toxicity such as interstitial nephritis, pneumonitis, and myocarditis. The cornerstones of treatment are removal of the offending agent as well as prompt initiation of steroids. However, as seen in this case, the decline in eosinophils can lag behind the initiation of appropriate treatment. Furthermore, there are a small subset of cases of DRESS syndrome that appear to be refractory to steroids alone. When the patient's clinical condition continues to deteriorate despite appropriate treatment with steroids, additional immunomodulators should be considered.