Amoxicillin-induced exanthema in young adults with infectious mononucleosis: demonstration of drug-specific lymphocyte reactivity.
BACKGROUND
Teenagers and young adults frequently develop maculopapular exanthema following amoxicillin intake within infectious mononucleosis. The underlying pathomechanisms are still largely unknown.


OBJECTIVE
To investigate whether amoxicillin-induced exanthema in florid infectious mononucleosis is a disease-associated phenomenon or results from specific sensitization to the drug.


METHODS
Four patients with amoxicillin-induced exanthema within infectious mononucleosis were analysed in vivo by prick, intradermal and patch tests and in vitro by means of the lymphocyte transformation test (LTT) employing amoxicillin, ampicillin, benzylpenicillin and phenoxymethylpenicillin.


RESULTS
Drug-specific sensitization to amoxicillin in the LTT was observed in three patients, two of whom showed a side-chain-specific sensitization to amoxicillin and ampicillin. The in vitro results were confirmed in vivo by skin tests.


CONCLUSIONS
These data suggest that real sensitization to amoxicillin and ampicillin may occur within infectious mononucleosis and may be detected in vivo and in vitro by means of skin tests and the LTT.
Renn
C N
CN
Department of Dermatology and Allergology, University Hospitals, Rheinisch-Westfälische Technische Hochschule Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany. Claudia.Renn@post.de
Straff
W
W
Dorfmüller
A
A
Al-Masaoudi
T
T
Merk
H F
HF
Sachs
B
B
D000328:Adult; D000658:Amoxicillin / Q000009:adverse effects*; D018929:Cell Culture Techniques; D003875:Drug Eruptions / Q000209:etiology* / Q000276:immunology; D005076:Exanthema / Q000139:chemically induced* / Q000276:immunology; D005260:Female; D006801:Humans; D007244:Infectious Mononucleosis / Q000188:drug therapy*; D008213:Lymphocyte Activation / Q000187:drug effects; D008297:Male; D010406:Penicillins / Q000009:adverse effects*; D012882:Skin Tests / Q000379:methods
D010406:Penicillins; D000658:Amoxicillin