title: Metronidazole hypersensitivity.
abstract: 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.
authors.affiliation: Department of Pharmacy, Sunnybrook Health Science Centre, North York, Ontario, Canada.
authors.forename: S
authors.initials: S
authors.lastname: Knowles
authors.forename: T
authors.initials: T
authors.lastname: Choudhury
authors.forename: N H
authors.initials: NH
authors.lastname: Shear
mesh_terms: 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*
chemical_list: D009761:Nystatin; D008795:Metronidazole