January 15, 2015

Amoxicillin rash in patients with infectious mononucleosis: evidence of true drug sensitization

Short report

Open Access

Katinka Ónodi-NagyÁgnes KinyóAngéla MeszesEdina GaracziLajos Kemény and Zsuzsanna Bata-Csörg¿

Abstract (provisional)

Background

It hasn't been clearly understood yet whether sensitization to antibiotics, the virus itself or transient loss of drug tolerance due to the virus, is responsible for the development of maculopapular exanthems following amoxicillin intake in patients with infectious mononucleosis. We aimed to examine whether sensitization to penicillin developed among patients with skin rash following amoxicillin treatment within infectious mononucleosis.

Methods

Ten patients were investigated for drug sensitization by lymphocyte transformation test and six patients were further tested by prick-, intradermal and patch tests employing the penicillin's main antigens.

Results

Lymphocyte transformation test showed negative results with amoxicillin, while one patient had positive reaction to cefixime. Six patients with suspected sensitization to amoxicillin were then investigated by in vivo tests. Prick tests were negative in all six patients, but the intradermal tests showed positive reactions in four patients.

Conclusions

Our data demonstrate that in vitro testing is not sensitive enough in determining drug sensitization to penicillin. In vivo tests should be performed to detect sensitization and indeed with skin tests our results confirmed that sensitization to aminopenicillin may develop within infectious mononucleosis.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

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