Maculopapular rash with multiple drug hypersensitivity to cotrimoxazole, amikacin, piperacillin/tazobactam, and meropenem in a patient with hairy cell leukemia
K. Townsend1, 3, 4, C. Leck1, T. Billahalli1, E. Barachina1, T.J. Watts1, 2
1 Department of Respiratory Medicine & Allergy, Homerton Healthcare NHS Foundation Trust, 2 National Heart & Lung Institute, Imperial College London, 3 Department of Immunology,
Royal Free London Hospital NHS Foundation Trust, 4 University College London Institute of
Immunity and Transplantation, Pears building, London, United Kingdom
DOI 10.5414/ALX02508
Abstrakt
We describe a rare case of a 54-year-old female with hairy cell leukemia, who following treatment for neutropenic sepsis, developed an extensive severe maculopapular exanthema with perifollicular hemorrhage. Cladribine, cotrimoxazole, allopurinol, domperidone, amikacin, piperacillin/tazobactam, and meropenem had all been given in the 9 days prior to eruption onset. Three months later, drug patch testing/delayed intradermal testing was positive to cotrimoxazole, trimethoprim, amikacin, piperacillin/tazobactam, and meropenem, with additional evidence of penicillin cross-reactivity. Drug challenge tests were negative to allopurinol and domperidone. She was diagnosed with multiple drug hypersensitivity to cotrimoxazole, amikacin, piperacillin/tazobactam, and meropenem. Multiple drug hypersensitivity is a novel syndrome mainly seen with severe delayed type IV drug eruptions, involving long-lasting strong T-cell reactivity to two or more structurally unrelated drugs.
Autoreninformation
Autoren
Abteilungen
- 1 Department of Respiratory Medicine & Allergy, Homerton Healthcare NHS Foundation Trust,
- 2 National Heart & Lung Institute, Imperial College London,
- 3 Department of Immunology,
Royal Free London Hospital NHS Foundation Trust, - 4 University College London Institute of
Immunity and Transplantation, Pears building, London, United Kingdom
Adresse
Dr. Katie Townsend, BM BCh, MRCP
UCL Pears Building
Rowland Hill Street
London, NW3 2QG, UK
Email:
[email protected]
Citation
K. Townsend, C. Leck, T. Billahalli, E. Barachina und T.J. Watts. Makulopapulöses Exanthem mit Multiple Drug Hypersensitivity Syndrom gegen Cotrimoxazol, Amikacin, Piperacillin/Tazobactam und Meropenem bei einer Patientin mit Haarzellleukämie. 2025; 48: 643-648. doi: 10.5414/ALX02508.