Titre du document / Document title

Eruption associated with amoxicillin in a patient with infectious mononucleosis

Auteur(s) / Author(s)

LEUNG Alexander K. C. ⁽¹⁾ ; RAFAAT Massoud ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Pediatrics, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, CANADA

Résumé / Abstract

A 9-year-old boy presented with a history of fever, malaise, and sore throat for 1 day. He was seen by his family physician who diagnosed tonsillitis. The past medical history was unremarkable. There was no previous history of allergy to medications. After a throat swab had been taken and sent for bacterial culture, the patient was started on amoxicillin, 250 mg three times daily. Two days later, the child developed an extensive pruritic eruption over the body. We were consulted at this point. On examination, the child was afebrile. His pulse rate was 74/min and his blood pressure was 90/60 mmHg. An erythematous, maculopapular eruption was noted on the face, neck, trunk, buttocks, and extremities ( Fig. 1). The palms and soles were also involved, but to a lesser extent. The pharynx and tonsils were erythematous. Yellowish exudates were seen in the tonsillar area. There were shotty lymph nodes in the cervical area. The spleen and liver were not palpable. The rest of the physical examination was normal. A provisional diagnosis of infectious mononucleosis was made. In the meantime, the throat swab culture came back as negative. Amoxicillin therapy was discontinued. Hydroxyzine hydrochloride, 10 mg four times daily as required, was given to relieve the itchiness. Laboratory investigations showed a hemoglobin of 125 g/L, white blood cell count of 12 x 10⁹/ L with 75% lymphocytes, 23% neutrophils, 5% monocytes, and 2% eosinophils, and a platelet count of 200 x 10⁹/L. Many atypical lymphocytes were seen in the peripheral smear. Monospot test was positive, confirming the diagnosis of infectious mononucleosis. The child was reassessed 7 days later. By then, the pruritus had subsided and the eruption had cleared without desquamation. The pharynx and tonsils looked normal and there was no cervical lymphadenopathy. The child was seen by his family physician 5 months later because of a left-sided earache. He was diagnosed with left otitis media and was treated with amoxicillin, 250 mg three times daily for 7 days. No skin eruption was noted with the use of amoxicillin on this occasion.

Revue / Journal Title

International journal of dermatology   ISSN 0011-9059   CODEN IJDEBB 

Source / Source

2003, vol. 42, n^o7, pp. 553-555 [3 page(s) (article)] (15 ref.)

Langue / Language

Anglais

Editeur / Publisher

Blackwell Science, Oxford, ROYAUME-UNI  (1970) (Revue)

Mots-clés anglais / English Keywords

Skin disease ; Infection ; Viral disease ; Human ; Penicillin derivatives ; β-Lactams ; Skin ; Exanthema ; Toxicity ; Infectious mononucleosis ; Amoxicillin ; Child ; Case study ;

Mots-clés français / French Keywords

Peau pathologie ; Infection ; Virose ; Homme ; Pénicilline dérivé ; β-Lactamines ; Peau ; Exanthème ; Toxicité ; Mononucléose infectieuse ; Amoxicilline ; Enfant ; Etude cas ;

Mots-clés espagnols / Spanish Keywords

Piel patología ; Infección ; Virosis ; Hombre ; Penicilinas ; β-Lactams ; Piel ; Exantema ; Toxicidad ; Mononucleosis infecciosa ; Amoxicilina ; Niño ; Estudio caso ;

Localisation / Location

INIST-CNRS, Cote INIST : 11580, 35400011855674.0120