scholarly journals Viral Infections and Cutaneous Drug-Related Eruptions

2021 ◽  
Vol 11 ◽  
Author(s):  
Eleonora Anci ◽  
Camille Braun ◽  
Annalisa Marinosci ◽  
Frédérique Rodieux ◽  
Elise Midun ◽  
...  
Keyword(s):  
Drug Reaction ◽  
Viral Infections ◽  
Current Knowledge ◽  
Drug Hypersensitivity ◽  
Acute Infection ◽  
Maculopapular Rash ◽  
Skin Lesions ◽  
Drug Induced ◽  
Barr Virus ◽  
Systemic Symptoms

In the general population, up to 10% of children treated by antibiotics have cutaneous adverse drug reaction, but allergy is confirmed in less than 20% of patients. Most of the non-allergic reactions are probably due to virus, such as enterovirus acute infection or Ebstein-Barr Virus (EBV) acute infection or reactivation. Especially in children, viruses have the propensity to induce skin lesions (maculopapular rash, urticaria) due to their skin infiltration or immunologic response. In drug-related skin eruptions, a virus can participate by activating an immune predisposition. The culprit antibiotic is then the trigger for reacting. Even in severe drug-induced reactions, such as Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome, viruses take part in immune phenomena, especially herpes viruses. Understanding the mechanisms of both virus- and drug-induced skin reaction is important to develop our clinical reflection and give an adaptive care to the patient. Our aim is to review current knowledge on the different aspects and potential roles of viruses in the different type of drug hypersensitivity reactions (DHR). Although major advances have been made those past year, further studies are needed for a better understanding of the link between viruses and DHR, to improve management of those patients.

scholarly journals A probable case of sodium valproate monotherapy induced drug reaction with eosinophilia and systemic symptoms syndrome: a case report in Indian population

2020 ◽  
Vol 9 (6) ◽  
pp. 991
Author(s):  
Vijayamathy Arunnair ◽  
Girish Kumaraswamy ◽  
Ramesh M.
Keyword(s):  
Drug Reaction ◽  
Bipolar Disorders ◽  
Maculopapular Rash ◽  
Hypersensitivity Syndrome ◽  
Dress Syndrome ◽  
Drug Induced ◽  
Probable Case ◽  
History Of ◽  
Systemic Symptoms ◽  
Generalized Lymphadenopathy

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a drug-induced hypersensitivity syndrome most commonly caused by anti-epileptics like carbamazepine, phenytoin. It usually manifests as maculopapular rash, fever, eosinophilia, generalized lymphadenopathy, hepatitis, atypical lymphocytosis, and leucocytosis with the involvement of other organs. Valproate, a broad-spectrum antiepileptic, also used in bipolar disorders and migraine prophylaxis, is generally well tolerated. To date, very few cases of valproate monotherapy induced DRESS syndrome have been reported worldwide and here we are reporting one such rare case in a 72 years old Indian woman with a history of generalised tonic convulsions. The patient was classified as a ‘probable’ case of DRESS syndrome using the WHO-UMC criteria and Naranjo scale. Discontinuation of the offending medication and treatment with intravenous (IV) fluids, antihistamines, and steroids helped in recovery of the patient. Healthcare practitioners must be aware of valproate monotherapy induced DRESS syndrome and take effective measures to avoid severe side effects. 

Evaluation of Clinical Properties and Diagnostic Test Results of Cephalosporin Allergy in Children

2021 ◽  
pp. 1-7
Author(s):  
Ozge Yilmaz Topal ◽  
Ilknur Kulhas Celik ◽  
Irem Turgay Yagmur ◽  
Muge Toyran ◽  
Ersoy Civelek ◽  
...  
Keyword(s):  
Drug Reaction ◽  
Diagnostic Test ◽  
Pediatric Patients ◽  
Drug Hypersensitivity ◽  
Maculopapular Rash ◽  
Test Results ◽  
Pediatric Allergy ◽  
Fixed Drug ◽  
Drug Hypersensitivity Reactions ◽  
Immediate Reactions

Introduction: Beta-lactams (BLs) are one of the most frequent causes of drug hypersensitivity reactions (HRs), and cephalosporins are a widely used subclass of BLs, especially in children. The aim of this study was to evaluate the clinical features and diagnostic test results of pediatric patients evaluated for suspected cephalosporin allergy. Methods: This study included patients who presented to our pediatric allergy clinic with a history of reactions attributed to cephalosporins between January 1, 2011, and December 31, 2019, and whose diagnostic tests were completed for the diagnosis. Results: This study included 120 pediatric patients and 69 (57.5%) of them were girls. The median age was 38.63 (interquartile range 10.5–85.7) months. Reactions occurring within 1 h of drug intake were reported in 33 patients (27.5%). Reactions were maculopapular rash in 55 (45.8%) patients, urticaria and/or angioedema in 49 (40.8%), anaphylaxis in 11 (9.2%), severe cutaneous drug reaction in 4 (3.3%), and fixed drug reaction in 1 patient (0.83%). The most frequently suspected agent was cefixime in 41 patients (34.2%). In total, 30 (25%) patients were diagnosed as having cephalosporin hypersensitivity. Confirmation of HRs was also significantly more frequent among patients who were older (p: 0.000), who had taken the drug parenterally (p: 0.000) and with immediate reactions (p: 0.000). Conclusion: Cephalosporin allergy has been confirmed in approximately one-fourth of the patients evaluated for suspected cephalosporin allergy. Confirmation of HRs was significantly more common among patients who were older, had immediate reactions, and had taken the drug parenterally.

Drug Hypersensitivity Syndrome Caused by Minocycline

2006 ◽  
Vol 10 (3) ◽  
pp. 131-135 ◽  
Author(s):  
Daisuke Tsuruta ◽  
Yukiko Someda ◽  
Junko Sowa ◽  
Hiromi Kobayashi ◽  
Masamitsu Ishii
Keyword(s):  
Drug Hypersensitivity ◽  
Human Herpesvirus ◽  
Oral Prednisolone ◽  
Liver Function Tests ◽  
Hypersensitivity Syndrome ◽  
Skin Lesions ◽  
Japanese Woman ◽  
Barr Virus ◽  
Epstein Barr ◽  
Drug Hypersensitivity Syndrome

Background: Minocycline is a commonly prescribed drug for the treatment of acne. Its use is generally not associated with systemic side effects. Objective: To describe a case of minocycline-induced drug hypersensitivity syndrome in a 20-year-old Japanese woman. Methods and Results: Following 2 months of minocycline treatment, the patient developed skin lesions composed of exudative maculopapules, purpuratous macules, and target-like, erythema multiforme-like plaques over most of her body. In addition, she had fever, abnormal liver function tests, eosinophilia, and atypical lymphocytosis. Laboratory tests indicated no elevation of antibody titers against cytomegalovirus, Epstein-Barr virus, and human herpesvirus 6. Her ongoing exposure to minocycline was stopped, and treatment with oral prednisolone was begun. Her signs, symptoms, and laboratory abnormalities then began to resolve. Subsequently, the syndrome was observed to return briefly in response to an oral challenge with minocycline. Conclusions: Minocycline is able to elicit a drug hypersensitivity syndrome that can resemble infectious mononucleosis. This drug reaction can be treated effectively by cessation of exposure to this drug and steroid therapy.

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