title: Azithromycin-induced rash in a patient of infectious mononucleosis - a case report with review of literature.
abstract: Antibiotic induced skin rash in setting of infectious mononucleosis is often encountered in clinical practice. However, macrolides like azithromycin are considered relatively safe and till date only two cases of azithromycin induced rash in setting of infectious mononucleosis have been reported. The following report illustrates the case of a 23-year-old man suffering from infectious mononucleosis who exhibited a generalized cutaneous rash following treatment with azithromycin. Using the Naranjo ADR probability scale, this case of acute onset rash following azithromycin administration was found to be in 'probable' category. The mechanism of antibiotic-induced rash in patients suffering from infectious mononucleosis is incompletely understood. It has been suggested that the rash could result from virus mediated immunomodulation or due to altered drug metabolism. The report calls for cautious use of antibiotics in the setting of suspected viral infections like infectious mononucleosis as injudicious use might increase the risk of deleterious skin reactions and increase the cost of healthcare.
authors.affiliation: Final year Post-Doctoral Trainee, Department of Clinical and Experimental Pharmacology, School of Tropical Medicine , Kolkata, West Bengal, India .
authors.forename: Indranil
authors.initials: I
authors.lastname: Banerjee
authors.affiliation: Technical Associate, ADR Monitoring Centre, Department of Clinical and Experimental Pharmacology, School of Tropical Medicine , Kolkata, West Bengal, India .
authors.forename: Somnath
authors.initials: S
authors.lastname: Mondal
authors.affiliation: Second Year Post-Doctoral Trainee, Department of Clinical and Experimental Pharmacology, School of Tropical Medicine , Kolkata, West Bengal, India .
authors.forename: Sukanta
authors.initials: S
authors.lastname: Sen
authors.affiliation: Professor and Head, Department of Clinical and Experimental Pharmacology, School of Tropical Medicine , Kolkata, West Bengal, India .
authors.forename: Santanu Kumar
authors.initials: SK
authors.lastname: Tripathi
authors.affiliation: Professor and Head, Department of Dermatology, School of Tropical Medicine , Kolkata, India .
authors.forename: Gautam
authors.initials: G
authors.lastname: Banerjee
keywords: Azithromycin; Infectious Mononucleosis; Rash