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Children with down syndrome often have an increased predisposition to recurrent viral related wheezing episodes and other issues like increased oropharyngeal secretions due to hypotonia. Lower airway anomalies such as tracheobronchomalacia and tracheal stenosis are also common. Children with tracheal abnormalities may have a chronic cough or noisy breathing and these conditions are often misdiagnosed as asthma. Here, we present a case report of a six-month-old baby with down syndrome who was misdiagnosed as having bronchial asthma at two months of age because of recurrent episodes of noisy breathing and was prescribed oral steroids which the parents continued in an unsupervised manner. The child presented with increased buccal fat and buffalo hump and was diagnosed as iatrogenic cushing syndrome after investigations. Steroids were gradually tapered and stopped gradually. On follow-up the child had fully recovered and had no signs of hypercortisolism.

Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome is often an overlooked entity manifesting as fatal hypersensitivity response associated with use of aromatic anti-epileptic drugs. This case report shows a case of a nine-year-old male child presenting with DRESS syndrome associated with the use of oral carbamazepine. The patient presented with high grade fever, rashes in exposed areas of face and all extremities not involving palms, soles, or oral mucosa, periorbital oedema, and cervical lymphadenopathy. Patient was managed with oral prednisolone 1 mg/kg/day. Later the drug was changed to oral levetiracetam. Clinicians should always consider the possibility of DRESS syndrome with the use of anti-epileptic drugs.