nystatin-a1 and Drug-Hypersensitivity

Despite its widespread use, the antimycotic nystatin rarely causes allergic reactions. We observed a case of acute generalized pustular exanthem with arthralgia and fever, after the oral administration of nystatin. A causal relationship was demonstrated by positive Intracutaneous testing of the drug. Immunohistology revealed positive staining for C3 in the test area, whereas circulating immune complexes could not be identified. These findings are compatible with a type-II allergic reaction. Systemic prednisolone treatment led to a complete remission of the clinical symptoms within 11 days. In two test subjects who had never received nystatin intracutaneous testing was initially negative. After 3 weeks, both developed itching erythematous papules at the injection sites. Therefore, intracutaneous testing of nystatin involves the risk of sensitization.

Topics: Adult; Antifungal Agents; Candidiasis; Diagnosis, Differential; Drug Eruptions; Drug Hypersensitivity; Female; Gastrointestinal Diseases; Humans; Intradermal Tests; Nystatin; Patch Tests; Skin Diseases, Vesiculobullous

Topics: Administration, Oral; Amoxicillin; Anti-Bacterial Agents; Antifungal Agents; Drug Eruptions; Drug Hypersensitivity; Erythema; Female; Humans; Lung Neoplasms; Male; Middle Aged; Mycoses; Nystatin; Opportunistic Infections; Patch Tests; Time Factors; Tooth Diseases; Withholding Treatment

To report a case of a possible hypersensitivity reaction induced by metronidazole.. An Asian woman with a history of recurrent vaginitis had previously developed localized erythema while on intravaginal metronidazole and nystatin. While receiving oral metronidazole for treatment of a current bacterial vaginosis, she developed chills, fever, generalized erythema, and a rash within 60 minutes of the first dose. Treatment with diphenhydramine was instituted. The following day while in the hospital, the patient's condition worsened; she experienced shortness of breath and increased edema of the extremities. Methylprednisolone was administered with diphenhydramine and her condition improved over the next 5 days. The patient's vaginitis was treated with gentian violet and she was discharged on a tapering dosage of prednisone.. Metronidazole-induced cutaneous reactions and systemic hypersensitivity reactions are reviewed. Alternatives to metronidazole and other potential cross-reactive drugs are suggested for the treatment of recurrent vaginitis.. Although the patient's initial reaction to metronidazole represented a rare event, written documentation and communication in the patient's native language may have prevented the subsequent severe hypersensitivity reaction.

Topics: Adult; Biological Availability; Candidiasis, Vulvovaginal; Drug Hypersensitivity; Drug Therapy, Combination; Female; Humans; Metronidazole; Nystatin; Recurrence; Vaginosis, Bacterial

Topics: Administration, Oral; Allergens; Dermatitis, Contact; Drug Hypersensitivity; Humans; Immunization; Male; Middle Aged; Nystatin

Topics: Adolescent; Child, Preschool; Dermatitis, Contact; Drug Eruptions; Drug Hypersensitivity; Eczema; Ethylenediamines; Female; Humans; Male; Neomycin; Nystatin; Skin Tests; Triamcinolone

Topics: Anti-Bacterial Agents; Cell Aggregation; Drug Hypersensitivity; Drug Industry; Environmental Exposure; Griseofulvin; Humans; Leukocyte Count; Leukocytes; Nystatin; Occupational Diseases; Oleandomycin; Tetracycline; Time Factors

Topics: Adult; Dermatitis, Contact; Drug Hypersensitivity; Female; Humans; Nystatin; Skin Tests; Vulva

Topics: Adolescent; Adrenocorticotropic Hormone; Ampicillin; Demeclocycline; Drug Hypersensitivity; Humans; Infectious Mononucleosis; Male; Nystatin; Penicillin G Benzathine; Pharyngitis; Phenothiazines; Streptococcal Infections; Triamcinolone Acetonide

Topics: Anti-Bacterial Agents; Cyanosis; Drug Eruptions; Drug Hypersensitivity; Edema; Episiotomy; Erythromycin Ethylsuccinate; Female; Fever; Hearing Disorders; Humans; Hysterectomy; Neomycin; Nystatin; Penicillins; Postoperative Care; Pregnancy; Pregnancy, Ectopic; Streptomycin; Tetracycline

Topics: Balanitis; Candidiasis, Cutaneous; Candidiasis, Oral; Candidiasis, Vulvovaginal; Dermatitis; Diabetes Complications; Drug Hypersensitivity; Female; Humans; Infant; Male; Middle Aged; Neomycin; Nystatin; Pregnancy; Pregnancy Complications, Infectious

Topics: Anaphylaxis; Anti-Bacterial Agents; Chloramphenicol; Colistin; Diagnosis; Drug Hypersensitivity; Humans; Hypersensitivity; Nystatin; Penicillins; Statistics as Topic; Streptomycin; Tetracycline; Toxicology