Metronidazole hypersensitivity.
OBJECTIVE
To report a case of a possible hypersensitivity reaction induced by metronidazole.


METHODS
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.


CONCLUSIONS
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.


CONCLUSIONS
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.
Knowles
S
S
Department of Pharmacy, Sunnybrook Health Science Centre, North York, Ontario, Canada.
Choudhury
T
T
Shear
N H
NH
D000328:Adult; D001682:Biological Availability; D002181:Candidiasis, Vulvovaginal / Q000188:drug therapy*; D004342:Drug Hypersensitivity; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008795:Metronidazole / Q000009:adverse effects* / Q000493:pharmacokinetics; D009761:Nystatin / Q000627:therapeutic use; D012008:Recurrence; D016585:Vaginosis, Bacterial / Q000188:drug therapy*
D009761:Nystatin; D008795:Metronidazole